Provider Demographics
NPI:1790181048
Name:ARTETA, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:ARTETA
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 1:288 N BROAD ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3711
Mailing Address - Country:US
Mailing Address - Phone:908-527-7926
Mailing Address - Fax:
Practice Address - Street 1:288 N BROAD ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3711
Practice Address - Country:US
Practice Address - Phone:908-527-7926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00718700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor