| Doctor Name: | DIANA FOGARTY |
| NPI Number: | 1184853848 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-R |
| License Number: | 076237 |
| Business Practice Address: | 11 Route 109 West Babylon, NY - 117046207 |
| Business Phone Number: | 6316695355 |
| Business Fax Number: | 6313215158 |
| Mailing Address: | 11 Route 109, WEST BABYLON |
| State: | NY |
| Postal Code: | 117046207 |
| Phone Number: | 6316695355 |
| Fax Number: | 6313215158 |
| NPI Enumeration Date: | 07/02/2009 |
| NPI Last Update Date: | 01/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 076237 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |