Provider Demographics
NPI:1912907486
Name:CYMERMAN, DIANE HOFFMAN (MD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:HOFFMAN
Last Name:CYMERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:45 RESEARCH WAY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-6401
Mailing Address - Country:US
Mailing Address - Phone:631-675-2125
Mailing Address - Fax:631-675-2624
Practice Address - Street 1:2500 NESCONSET HWY
Practice Address - Street 2:17-A
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2555
Practice Address - Country:US
Practice Address - Phone:631-751-6262
Practice Address - Fax:631-751-6268
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2016-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY161005207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A64982Medicare UPIN
95D141Medicare ID - Type Unspecified