Provider Demographics
NPI:1891162525
Name:MCLAUGHLIN, DIANA C (PT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:C
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3131
Mailing Address - Country:US
Mailing Address - Phone:845-565-5054
Mailing Address - Fax:
Practice Address - Street 1:260 NORTH ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3131
Practice Address - Country:US
Practice Address - Phone:845-565-5054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011275-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist