Provider Demographics
NPI:1639975295
Name:PAUL, DIANE
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:PAUL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CHARLIES PL
Mailing Address - Street 2:
Mailing Address - City:CHITTENANGO
Mailing Address - State:NY
Mailing Address - Zip Code:13037-1080
Mailing Address - Country:US
Mailing Address - Phone:315-382-8732
Mailing Address - Fax:
Practice Address - Street 1:111 CHARLIES PL
Practice Address - Street 2:
Practice Address - City:CHITTENANGO
Practice Address - State:NY
Practice Address - Zip Code:13037-1080
Practice Address - Country:US
Practice Address - Phone:315-382-8732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula