Provider Demographics
NPI:1972685998
Name:KUDES, DIANA B (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:B
Last Name:KUDES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:220 LINDEN OAKS SUITE 200
Mailing Address - Street 2:PANORAMA PEDIATRIC GROUP RLLP
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625
Mailing Address - Country:US
Mailing Address - Phone:585-381-4982
Mailing Address - Fax:585-381-1821
Practice Address - Street 1:2705 DEKALB PIKE STE 202
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401
Practice Address - Country:US
Practice Address - Phone:610-275-7240
Practice Address - Fax:610-275-0633
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2018-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD430883208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02730665Medicaid