Provider Demographics
NPI:1467701193
Name:BEYNIN, DIANA (DC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:BEYNIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 MAIN ST
Mailing Address - Street 2:9A
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2123
Mailing Address - Country:US
Mailing Address - Phone:201-478-3248
Mailing Address - Fax:908-688-0688
Practice Address - Street 1:515 MAIN ST
Practice Address - Street 2:9A
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2123
Practice Address - Country:US
Practice Address - Phone:201-478-3248
Practice Address - Fax:908-688-0688
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00546500111NN0400X
NYX010149-1111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology