Provider Demographics
NPI:1982685210
Name:CARNEY, DIANNE M (FNPC)
Entity Type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:M
Last Name:CARNEY
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-1614
Mailing Address - Country:US
Mailing Address - Phone:607-324-1000
Mailing Address - Fax:607-324-7785
Practice Address - Street 1:32 GENESEE ST
Practice Address - Street 2:HSG
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-1614
Practice Address - Country:US
Practice Address - Phone:607-324-1000
Practice Address - Fax:607-324-7785
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3310271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02429096Medicaid
NYBB9756Medicare ID - Type Unspecified
R82732Medicare UPIN