Provider Demographics
NPI:1407036544
Name:DIANE DESCHINO, MD, PC
Entity Type:Organization
Organization Name:DIANE DESCHINO, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DESCHINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-634-7878
Mailing Address - Street 1:180 PHILLIPS HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-4132
Mailing Address - Country:US
Mailing Address - Phone:845-634-7878
Mailing Address - Fax:845-634-7883
Practice Address - Street 1:180 PHILLIPS HILL RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4132
Practice Address - Country:US
Practice Address - Phone:845-634-7878
Practice Address - Fax:845-634-7883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204969207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG87482Medicare UPIN
NYWEN161Medicare PIN