Provider Demographics
NPI:1467248385
Name:DIEKMANN, ELISABETH HARVEY
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:HARVEY
Last Name:DIEKMANN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 MERCER ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-1502
Mailing Address - Country:US
Mailing Address - Phone:212-677-3400
Mailing Address - Fax:212-995-5897
Practice Address - Street 1:190 MERCER ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1502
Practice Address - Country:US
Practice Address - Phone:212-677-3400
Practice Address - Fax:212-995-5897
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCRPA-2643175T00000X
CRPA-2643175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist