Provider Demographics
NPI:1639621204
Name:DIANE L. ESPER
Entity Type:Organization
Organization Name:DIANE L. ESPER
Other - Org Name:PRIVATE PSYCHOTHERAPY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PSYCHOANALYST
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:ESPER
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:917-841-2459
Mailing Address - Street 1:15 FORT CHARLES PL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-6704
Mailing Address - Country:US
Mailing Address - Phone:917-841-2459
Mailing Address - Fax:
Practice Address - Street 1:412 6TH AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8409
Practice Address - Country:US
Practice Address - Phone:917-841-2459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000721302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization