Provider Demographics
NPI:1386660108
Name:PISARCIK, DIANA L (MS, RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:L
Last Name:PISARCIK
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:MISS
Other - First Name:DIANA
Other - Middle Name:LYNN
Other - Last Name:ISENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1367 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3546
Mailing Address - Country:US
Mailing Address - Phone:724-349-0863
Mailing Address - Fax:
Practice Address - Street 1:841 HOSPITAL RD STE 3500
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3659
Practice Address - Country:US
Practice Address - Phone:724-349-8636
Practice Address - Fax:724-465-4087
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002037133V00000X, 133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Not Answered133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal