Provider Demographics
NPI:1760924674
Name:FRANSIS, DIANA IBRAHIM (RD)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:IBRAHIM
Last Name:FRANSIS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 VOORHEES AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLESEX
Mailing Address - State:NJ
Mailing Address - Zip Code:08846-2362
Mailing Address - Country:US
Mailing Address - Phone:732-322-3632
Mailing Address - Fax:
Practice Address - Street 1:384 VOORHEES AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:NJ
Practice Address - Zip Code:08846-2362
Practice Address - Country:US
Practice Address - Phone:732-322-3632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1070100133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered