Provider Demographics
NPI:1942331459
Name:DIVEN, JUDITH C (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:C
Last Name:DIVEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 WASHINGTON RD
Mailing Address - Street 2:#203
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228
Mailing Address - Country:US
Mailing Address - Phone:412-563-5777
Mailing Address - Fax:412-563-0122
Practice Address - Street 1:520 WASHINGTON RD
Practice Address - Street 2:#203
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228
Practice Address - Country:US
Practice Address - Phone:412-563-5777
Practice Address - Fax:412-563-0122
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD18485E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104233OtherHIGHMARK BLUE SHIELD
PA1451593OtherHIGHMARK BLUE SHIELD
PA1438820OtherHIGHMARK BCBS
PA104233OtherHIGHMARK BCBS
PA1438820OtherHIGHMARK BCBS