Provider Demographics
NPI:1295440246
Name:FRIED, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:FRIED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LAUREL HILL DR
Mailing Address - Street 2:
Mailing Address - City:LEVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:01054-9563
Mailing Address - Country:US
Mailing Address - Phone:505-281-2969
Mailing Address - Fax:
Practice Address - Street 1:30 LAUREL HILL DR
Practice Address - Street 2:
Practice Address - City:LEVERETT
Practice Address - State:MA
Practice Address - Zip Code:01054-9563
Practice Address - Country:US
Practice Address - Phone:505-281-2969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist