Provider Demographics
NPI:1982753349
Name:DIAMENT PSYCH ASSOCIATES QTS, LLC
Entity Type:Organization
Organization Name:DIAMENT PSYCH ASSOCIATES QTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:DIAMENT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-695-1809
Mailing Address - Street 1:655 SHREWSBURY AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4179
Mailing Address - Country:US
Mailing Address - Phone:732-695-1809
Mailing Address - Fax:732-933-1860
Practice Address - Street 1:655 SHREWSBURY AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4179
Practice Address - Country:US
Practice Address - Phone:732-695-1809
Practice Address - Fax:732-933-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty