Provider Demographics
NPI:1912926254
Name:DIAMOND, SHARI ELLEN (DO)
Entity Type:Individual
Prefix:DR
First Name:SHARI
Middle Name:ELLEN
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:46 SOURLAND HILLS RD
Mailing Address - Street 2:
Mailing Address - City:SKILLMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08558-1519
Mailing Address - Country:US
Mailing Address - Phone:609-466-4935
Mailing Address - Fax:609-530-0966
Practice Address - Street 1:2500 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4134
Practice Address - Country:US
Practice Address - Phone:609-771-6660
Practice Address - Fax:609-530-0966
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ51984207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE53546Medicare UPIN