Provider Demographics
NPI:1982913455
Name:REICHBIND, DIANA (PA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:REICHBIND
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:MLYNARSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2 IVY BROOK RD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6416
Mailing Address - Country:US
Mailing Address - Phone:203-538-5400
Mailing Address - Fax:203-538-5327
Practice Address - Street 1:2 IVY BROOK RD
Practice Address - Street 2:SUITE 213
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6416
Practice Address - Country:US
Practice Address - Phone:203-538-5400
Practice Address - Fax:203-538-5327
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002479363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant