Provider Demographics
NPI:1104084649
Name:FRESCA, DIANE E (MD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:E
Last Name:FRESCA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:601 EWING ST
Mailing Address - Street 2:SUITE C-8
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2757
Mailing Address - Country:US
Mailing Address - Phone:609-924-4433
Mailing Address - Fax:609-924-4423
Practice Address - Street 1:601 EWING ST
Practice Address - Street 2:SUITE C-8
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2757
Practice Address - Country:US
Practice Address - Phone:609-924-4433
Practice Address - Fax:609-924-4423
Is Sole Proprietor?:No
Enumeration Date:2008-05-31
Last Update Date:2014-12-17
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07686400207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091496Medicare PIN
NJI30620Medicare UPIN