Provider Demographics
NPI:1518232461
Name:DIDUCH, DIANA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:DIDUCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 OUTWATER LN
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-3859
Mailing Address - Country:US
Mailing Address - Phone:973-772-2937
Mailing Address - Fax:973-772-7086
Practice Address - Street 1:45 OUTWATER LN
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-3859
Practice Address - Country:US
Practice Address - Phone:973-772-2937
Practice Address - Fax:973-772-7086
Is Sole Proprietor?:No
Enumeration Date:2012-03-11
Last Update Date:2012-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03227900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist