Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | N005301-1 | NY |
N | 222Z00000X | Podiatrist | N005301-1 | NY |
N | 213EP1101X | Primary Podiatric Medicine | N005301-1 | NY |
N | 2081S0010X | Sports Medicine | N005301-1 | NY |
N | 213ES0000X | Sports Medicine | N005301-1 | NY |
N | 213ES0131X | Foot Surgery | N005301-1 | NY |
NPI | 1538151444 |
---|---|
Provider Name | Dr. Diane M Infantine-Vyce |
First Address | Guilderland, NY 12084-0926 |
Second Address | Guilderland, NY 12084-9511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U74075 | (02) |