Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 38MC00546500 | NJ |
N | 111NN0400X | Neurology | X010149-1 | NY |
NPI | 1467701193 |
---|---|
Provider Name | Diana Beynin |
First Address | Chatham, NJ 07928-2123 |
Second Address | Chatham, NJ 07928-2123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2012 |
Last Update Date | 10/09/2012 |