Provider Demographics
NPI:1912969940
Name:WORMSER, DIANE (PT, MS)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:
Last Name:WORMSER
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 RTE 202-206
Mailing Address - Street 2:SUNDANCE AT CHELSEA
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-1767
Mailing Address - Country:US
Mailing Address - Phone:908-253-0915
Mailing Address - Fax:908-253-0915
Practice Address - Street 1:680 RTE 202-206
Practice Address - Street 2:SUNDANCE AT CHELSEA
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-1767
Practice Address - Country:US
Practice Address - Phone:908-253-0915
Practice Address - Fax:908-253-0915
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist