Provider Demographics
NPI:1679835565
Name:BOEKMAN, DIANE (MED, BS)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:
Last Name:BOEKMAN
Suffix:
Gender:F
Credentials:MED, BS
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:EHRMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, BS
Mailing Address - Street 1:1053 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-1048
Mailing Address - Country:US
Mailing Address - Phone:914-674-0733
Mailing Address - Fax:
Practice Address - Street 1:1053 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1048
Practice Address - Country:US
Practice Address - Phone:914-674-0733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist