Provider Demographics
NPI:1760713606
Name:HART, DIANE HELEN
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:HELEN
Last Name:HART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 KINGS MILL CT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3632
Mailing Address - Country:US
Mailing Address - Phone:518-456-1058
Mailing Address - Fax:
Practice Address - Street 1:10 KINGS MILL CT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3632
Practice Address - Country:US
Practice Address - Phone:518-456-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer