Provider Demographics
NPI:1134236177
Name:KMEC, DIANE J (MD,LLC)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:J
Last Name:KMEC
Suffix:
Gender:F
Credentials:MD,LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 RED FOX CT
Mailing Address - Street 2:
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-1722
Mailing Address - Country:US
Mailing Address - Phone:908-208-8628
Mailing Address - Fax:
Practice Address - Street 1:45 RED FOX CT
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-1722
Practice Address - Country:US
Practice Address - Phone:908-208-8628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA039740207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56320Medicare UPIN
NJ088323Medicare PIN