Provider Demographics
NPI:1679396576
Name:DEMORATO, DIANA (LMSW)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:DEMORATO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 STAFFORD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2312
Mailing Address - Country:US
Mailing Address - Phone:347-838-1971
Mailing Address - Fax:
Practice Address - Street 1:8403 CUTHBERT RD
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2140
Practice Address - Country:US
Practice Address - Phone:800-278-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist