Korzeniewski, Diane Bardina

Korzeniewski, Diane Bardina is an sole proprietor health care provider with primary practice located at 545 Old Norcross Rd Suite 100, Lawrenceville GA 30046-3389. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Korzeniewski, Diane Bardina can be contacted via phone (678) 377-2833.

Contact Information

Primary practice address
545 Old Norcross Rd Suite 100 Lawrenceville GA 30046-3389
Phone: (678) 377-2833
Fax: (678) 377-2882
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT003986 Georgia

Profile Details

NPI number 1700944568
LBN Legal business name Korzeniewski, Diane Bardina
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 5th, 2006
Last updated Sep 28th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700944568 NPPES
Georgia MEDICAID 183063315A
Georgia Other 340243
Georgia Other 10037631

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