Provider Demographics
NPI:1427175348
Name:BOARO, DIANE E (APRN, MS, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:E
Last Name:BOARO
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Gender:
Credentials:APRN, MS, PMHNP-BC
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Mailing Address - Street 1:186 POND VIEW LN
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-5200
Mailing Address - Country:US
Mailing Address - Phone:516-721-1976
Mailing Address - Fax:631-689-2055
Practice Address - Street 1:186 POND VIEW LN
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-5200
Practice Address - Country:US
Practice Address - Phone:516-721-1976
Practice Address - Fax:631-689-2055
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF400809363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health