Provider Demographics
NPI:1659671816
Name:DINARDO, DIANA LYNN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DIANA LYNN
Middle Name:
Last Name:DINARDO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 KOFLER AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1823
Mailing Address - Country:US
Mailing Address - Phone:716-873-9774
Mailing Address - Fax:
Practice Address - Street 1:36 KOFLER AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1823
Practice Address - Country:US
Practice Address - Phone:716-873-9774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109937-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse