Provider Demographics
NPI:1285061002
Name:ROONEY, DIANE
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:ROONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W 72ND ST
Mailing Address - Street 2:#801
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4199
Mailing Address - Country:US
Mailing Address - Phone:917-847-6615
Mailing Address - Fax:
Practice Address - Street 1:50 W 72ND ST
Practice Address - Street 2:#801
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4199
Practice Address - Country:US
Practice Address - Phone:917-847-6615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002134-1171100000X
NJ25MZ00029900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist