Provider Demographics
NPI:1851371538
Name:CIAGLIA, DIANE M (DO)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:CIAGLIA
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:531 MT PLEASANT DR
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1987
Practice Address - Country:US
Practice Address - Phone:570-342-8500
Practice Address - Fax:570-558-2290
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2021-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS011241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001944386Medicaid
PA068208LZRMedicare PIN