Provider Demographics
NPI:1902103328
Name:CURTIS, DIANE
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:CURTIS
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 1:519 MADISON DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-5326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:292 APPLEGARTH RD
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-3754
Practice Address - Country:US
Practice Address - Phone:609-860-8122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01340500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist