Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 274091 | NY |
N | 2080P0214X | Pediatric Pulmonologist | MD441936 | PA |
NPI | 1629366372 |
---|---|
Provider Name | Dr. Barry Lawrence Diener |
First Address | Stony Brook, NY 11790-0989 |
Second Address | East Setauket, NY 11733-4080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2011 |
Last Update Date | 25/06/2014 |