Provider Demographics
NPI:1710165972
Name:FIELD, DIANA MARIE (DPT)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:MARIE
Last Name:FIELD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:DIANA
Other - Middle Name:MARIE
Other - Last Name:JUSTICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 416501
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6501
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:
Practice Address - Street 1:310 OLD COUNTRY RD STE 104
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1763
Practice Address - Country:US
Practice Address - Phone:914-294-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-09
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029611225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist