Provider Demographics
NPI:1477645307
Name:NASH, DIANA ROBERTA (MA CT)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:ROBERTA
Last Name:NASH
Suffix:
Gender:F
Credentials:MA CT
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:BRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:245 E 58TH STREET
Mailing Address - Street 2:#21E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1356
Mailing Address - Country:US
Mailing Address - Phone:646-420-2277
Mailing Address - Fax:646-497-0297
Practice Address - Street 1:245 E 58TH STREET
Practice Address - Street 2:#21E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1356
Practice Address - Country:US
Practice Address - Phone:646-420-2277
Practice Address - Fax:646-497-0297
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health