Provider Demographics
NPI:1295286227
Name:YING, DIANA (CRNA)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:YING
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 SUNNYSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-3612
Mailing Address - Country:US
Mailing Address - Phone:908-425-8809
Mailing Address - Fax:
Practice Address - Street 1:53 SUNNYSIDE AVE
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-3612
Practice Address - Country:US
Practice Address - Phone:908-425-8809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-14
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR16760100163W00000X
NJ26NJ00681000367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse