Mackenzie, Diane
Mackenzie, Diane is an individual health care provider with primary practice located at 495 N 13Th St , Newark NJ 07107-1317. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Mackenzie, Diane can be contacted via phone (973) 268-1400.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 25MB07665200 | New Jersey |
Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 25MB07665200 | New Jersey |
Profile Details
NPI number | 1316931264 |
---|---|
LBN Legal business name | Mackenzie, Diane |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 7th, 2005 |
Last updated | May 7th, 2008 - about 16 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1316931264 | NPPES |
New Jersey | MEDICAID | 0023361 |
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