Provider Demographics
NPI:1497001705
Name:GARFINKLE, DIANE
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:GARFINKLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6636 YELLOWSTONE BLVD
Mailing Address - Street 2:APARTMENT 20H
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2510
Mailing Address - Country:US
Mailing Address - Phone:718-897-6249
Mailing Address - Fax:
Practice Address - Street 1:6636 YELLOWSTONE BLVD
Practice Address - Street 2:APARTMENT 20H
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2510
Practice Address - Country:US
Practice Address - Phone:718-897-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011429-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist