Provider Demographics
NPI:1811235773
Name:CHOMKO, DIANNE E (RN, CDE)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:E
Last Name:CHOMKO
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 CHEW ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-3648
Mailing Address - Country:US
Mailing Address - Phone:610-969-4370
Mailing Address - Fax:610-969-3023
Practice Address - Street 1:1627 CHEW ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3648
Practice Address - Country:US
Practice Address - Phone:610-969-4370
Practice Address - Fax:610-969-3023
Is Sole Proprietor?:No
Enumeration Date:2013-01-27
Last Update Date:2013-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN273319L163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator