| Doctor Name: | DIANE YACIUK |
| NPI Number: | 1003221326 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, BSN |
| License Number: | 481275 |
| Business Practice Address: | 301 N Washington St Ste 2300 Herkimer, NY - 133501299 |
| Business Phone Number: | 3158671176 |
| Business Fax Number: | 3158671612 |
| Mailing Address: | 301 N Washington St Ste 2300, HERKIMER |
| State: | NY |
| Postal Code: | 133501299 |
| Phone Number: | 3158671176 |
| Fax Number: | 3158671612 |
| NPI Enumeration Date: | 06/25/2014 |
| NPI Last Update Date: | 06/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 481275 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |