Provider Demographics
NPI:1851506828
Name:ROSENSTEIN, DIANA SHIRLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:SHIRLEY
Last Name:ROSENSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 OLD YORK RD
Mailing Address - Street 2:SUITE 521
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3706
Mailing Address - Country:US
Mailing Address - Phone:215-881-7790
Mailing Address - Fax:215-881-7787
Practice Address - Street 1:261 OLD YORK RD
Practice Address - Street 2:SUITE 521
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3706
Practice Address - Country:US
Practice Address - Phone:215-881-7790
Practice Address - Fax:215-881-7787
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X, 103TF0200X
PAPS004848L103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA563875OtherHIGHMARK
PA0001664023OtherIBX HIGHMARK
PA563875OtherHIGHMARK