Provider Demographics
NPI:1164226999
Name:DIACOVO, DANA (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:
Last Name:DIACOVO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 WALL ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4809
Mailing Address - Country:US
Mailing Address - Phone:845-943-3515
Mailing Address - Fax:845-943-3263
Practice Address - Street 1:67 WALL ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4809
Practice Address - Country:US
Practice Address - Phone:845-943-3515
Practice Address - Fax:845-943-3263
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421018163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool