Provider Demographics
NPI:1245863281
Name:DIABETICWATCHERS USA LLC
Entity type:Organization
Organization Name:DIABETICWATCHERS USA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OERMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORRAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-577-8994
Mailing Address - Street 1:30 GALESI DR STE 104B
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4840
Mailing Address - Country:US
Mailing Address - Phone:201-577-8994
Mailing Address - Fax:
Practice Address - Street 1:30 GALESI DR STE 104B
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-4840
Practice Address - Country:US
Practice Address - Phone:201-577-8994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No251S00000XAgenciesCommunity/Behavioral Health