Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | OS006732E | PA |
NPI | 1194774133 |
---|---|
Provider Name | Dr. Nicholas P Diamond |
First Address | Yardley, PA 19067-3466 |
Second Address | Elkins Park, PA 19027-1421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E79106 | (02) | PA |