Provider Demographics
NPI:1942413448
Name:DISABATINO, DIANE JEANE (APN)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:JEANE
Last Name:DISABATINO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 CENTRE RD
Mailing Address - Street 2:NEW CASTLE COUNTY DETENTION MEDICAL
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1268
Mailing Address - Country:US
Mailing Address - Phone:302-633-3121
Mailing Address - Fax:302-633-3147
Practice Address - Street 1:963 CENTRE RD
Practice Address - Street 2:NEW CASTLE COUNTY DETENTION MEDICAL
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1268
Practice Address - Country:US
Practice Address - Phone:302-633-3121
Practice Address - Fax:302-633-3147
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELJ-0000158363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics