Doctor Name: | DIANA DIGIACOMO |
NPI Number: | 1023494481 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 35SI00333500 |
Business Practice Address: | 830 Bear Tavern Rd Ewing, NJ - 086281020 |
Business Phone Number: | 8003703651 |
Business Fax Number: | 8605100020 |
Mailing Address: | 32 Norma Rd, HARRINGTON PARK |
State: | NJ |
Postal Code: | 076401707 |
Phone Number: | 2014031201 |
Fax Number: | |
NPI Enumeration Date: | 08/07/2015 |
NPI Last Update Date: | 08/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 35SI00333500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |