Provider Demographics
NPI:1336825702
Name:FEMIA, DIANA MARIA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIA
Last Name:FEMIA
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 1:9 GLENRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-5028
Mailing Address - Country:US
Mailing Address - Phone:516-462-1983
Mailing Address - Fax:
Practice Address - Street 1:239 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2516
Practice Address - Country:US
Practice Address - Phone:631-696-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant