Provider Demographics
NPI:1861680332
Name:DIBIASE, MARIA GIUSEPPINA (APN-C)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:GIUSEPPINA
Last Name:DIBIASE
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5207 BLVD EAST
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-3507
Mailing Address - Country:US
Mailing Address - Phone:201-974-0882
Mailing Address - Fax:
Practice Address - Street 1:5207 BLVD EAST
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-3507
Practice Address - Country:US
Practice Address - Phone:201-974-0882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00079300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health