Provider Demographics
NPI:1578708111
Name:MORGENTHALER, DIANE S (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:S
Last Name:MORGENTHALER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:501 CRESCENT ST
Mailing Address - Street 2:GRANOFF HEALTH CENTER
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1330
Mailing Address - Country:US
Mailing Address - Phone:203-392-6300
Mailing Address - Fax:203-392-6301
Practice Address - Street 1:501 CRESCENT ST
Practice Address - Street 2:GRANOFF HEALTH CENTER
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1330
Practice Address - Country:US
Practice Address - Phone:203-392-6300
Practice Address - Fax:203-392-6301
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT033164207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine