Provider Demographics
NPI:1275602344
Name:DIAO, CAROLINA EFREN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:EFREN
Last Name:DIAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 EWINGVILLE RD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-2425
Mailing Address - Country:US
Mailing Address - Phone:609-406-0181
Mailing Address - Fax:
Practice Address - Street 1:3131 PRINCETON PIKE STE 109
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2201
Practice Address - Country:US
Practice Address - Phone:609-633-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA718832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ053746C2DOtherMEDICARE PROVIDER NUMBER
NJD1053746Medicaid
NJH53671Medicare UPIN