Provider Demographics
NPI:1255578290
Name:MAGLIARO, DIANE REGINA (RD, CDC)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:REGINA
Last Name:MAGLIARO
Suffix:
Gender:F
Credentials:RD, CDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 BEAUVOIR AVE
Mailing Address - Street 2:OVERLOOK HOSPITAL, DIABETES CENTER
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901
Mailing Address - Country:US
Mailing Address - Phone:908-522-2000
Mailing Address - Fax:908-522-4895
Practice Address - Street 1:99 BEAUVOIR AVE
Practice Address - Street 2:OVERLOOK HOSPITAL, DIABETES CENTER
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901
Practice Address - Country:US
Practice Address - Phone:908-522-2000
Practice Address - Fax:908-522-4895
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ912389133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered