Provider Demographics
NPI:1144279878
Name:DIWAN, ADNAN K (MD)
Entity type:Individual
Prefix:DR
First Name:ADNAN
Middle Name:K
Last Name:DIWAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-682-6538
Mailing Address - Fax:914-682-6403
Practice Address - Street 1:1 THEALL RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1404
Practice Address - Country:US
Practice Address - Phone:914-848-8700
Practice Address - Fax:914-682-6403
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
13174011BOtherNHADMIN
13174011BOtherPOMCO
131740118OtherCIGNA
NYWEU121OtherMEDICARE GROUP
131740118OtherMAGNACARE
2129S1Medicare ID - Type Unspecified
131740118OtherCIGNA