Individual
DIANE M SIXSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
56-45 MAIN ST, NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS EMERGENCY DE, FLUSHING, NY 11355
(718) 670-1231
(516) 437-4167
Mailing address
1981 MARCUS AVE, SUITE 208, NEW HYDE PARK, NY 11042-1038
(718) 670-1651
(516) 437-4167
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
122203
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00229896
—
NY
Enumeration date
07/17/2006
Last updated
11/02/2010
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