Provider Demographics
NPI:1407902604
Name:SINGER, DIANE PATRICIA (MAPT)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:PATRICIA
Last Name:SINGER
Suffix:
Gender:F
Credentials:MAPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CEDARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-5603
Mailing Address - Country:US
Mailing Address - Phone:631-543-0464
Mailing Address - Fax:
Practice Address - Street 1:77 VETERANS MEMORIAL HWY
Practice Address - Street 2:SUITE 5
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3410
Practice Address - Country:US
Practice Address - Phone:631-499-4344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017647-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist