Provider Demographics
NPI:1528012549
Name:LOPUSNY, DIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:LOPUSNY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 NOBLE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4738
Mailing Address - Country:US
Mailing Address - Phone:203-874-2800
Mailing Address - Fax:203-874-0511
Practice Address - Street 1:88 NOBLE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4738
Practice Address - Country:US
Practice Address - Phone:203-874-2800
Practice Address - Fax:203-874-0511
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042248208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine