Provider Demographics
NPI:1306597026
Name:ROWEN DIANO MD PA
Entity type:Organization
Organization Name:ROWEN DIANO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROWEN
Authorized Official - Middle Name:GUMAPAS
Authorized Official - Last Name:DIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-744-7337
Mailing Address - Street 1:33 N FULLERTON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3644
Mailing Address - Country:US
Mailing Address - Phone:973-744-7337
Mailing Address - Fax:973-744-5035
Practice Address - Street 1:48 N FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3411
Practice Address - Country:US
Practice Address - Phone:973-744-7337
Practice Address - Fax:973-744-5049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty