Provider Demographics
NPI:1710166228
Name:TRIOLO, DIANE CECILIA (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:CECILIA
Last Name:TRIOLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 CEDAR LN STE 109
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4311
Mailing Address - Country:US
Mailing Address - Phone:201-379-5650
Mailing Address - Fax:201-357-8206
Practice Address - Street 1:222 CEDAR LN STE 109
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4311
Practice Address - Country:US
Practice Address - Phone:201-379-5650
Practice Address - Fax:201-357-8206
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09088200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist