Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 26NJ00077800 | NJ |
NPI | 1023148202 |
---|---|
Provider Name | Dianne C Lakata |
First Address | Flemington, NJ 08822-4603 |
Second Address | Flemington, NJ 08822-4603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 08/07/2007 |