Provider Demographics
NPI:1992042238
Name:NORMATOV, DIANA (SPECIAL EDUCATION)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:NORMATOV
Suffix:
Gender:F
Credentials:SPECIAL EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 STRATFORD RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-2634
Mailing Address - Country:US
Mailing Address - Phone:917-291-1843
Mailing Address - Fax:
Practice Address - Street 1:49 STRATFORD RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-2634
Practice Address - Country:US
Practice Address - Phone:917-291-1843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY854552174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY854552OtherSPECIAL EDUCATOR