Provider Demographics
NPI:1295757359
Name:DIAMOND, GIGI (MD)
Entity type:Individual
Prefix:
First Name:GIGI
Middle Name:
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 E NORTHFIELD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4802
Mailing Address - Country:US
Mailing Address - Phone:973-597-0900
Mailing Address - Fax:973-597-0910
Practice Address - Street 1:349 E NORTHFIELD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4802
Practice Address - Country:US
Practice Address - Phone:973-597-0900
Practice Address - Fax:973-597-0910
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA045093207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE95012Medicare UPIN
NJ679182NT1Medicare PIN