Moller, Diana
Moller, Diana is an sole proprietor health care provider with primary practice located at 10201 66Th Rd North Shore- Lij Forest Hills,, Forest Hills NY 11375-2029. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Moller, Diana can be contacted via phone (718) 830-4000.Contact Information
Primary practice address
10201 66Th Rd North Shore- Lij Forest Hills,
Forest Hills NY 11375-2029
Phone: (718) 830-4000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 018309-1 | New York |
Profile Details
| NPI number | 1477942639 |
|---|---|
| LBN Legal business name | Moller, Diana |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 12th, 2015 |
| Last updated | Jan 20th, 2015 - about 9 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 | 1477942639 | NPPES |
| New York | MEDICAID | 11-3465690 |
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