Provider Demographics
NPI:1679883987
Name:AMAR, DIANE (MS)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:
Last Name:AMAR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21102 75TH AVE
Mailing Address - Street 2:APT. 6L
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3352
Mailing Address - Country:US
Mailing Address - Phone:718-776-5840
Mailing Address - Fax:
Practice Address - Street 1:21102 75TH AVE
Practice Address - Street 2:APT. 6L
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3352
Practice Address - Country:US
Practice Address - Phone:718-776-5840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator