Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 159251 | NY |
Y | 111NI0900X | Internist | 159251 | NY |
N | 207R00000X | Internist | MA045328 | NJ |
N | 111NI0900X | Internist | MA045328 | NJ |
N | 207R00000X | Internist | ME69172 | FL |
N | 111NI0900X | Internist | ME69172 | FL |
NPI | 1003145699 |
---|---|
Provider Name | Dr. Diane Martire |
First Address | New York, NY 10069-0701 |
Second Address | New York, NY 10069-0701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2009 |
Last Update Date | 10/12/2009 |