Individual
DIANE GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2900 W QUEEN LN, SUITE 221H, PHILADELPHIA, PA 19129-1033
(215) 991-8532
(215) 843-5495
Mailing address
2900 W QUEEN LN, SUITE 221H, PHILADELPHIA, PA 19129-1033
(215) 991-8532
(215) 843-5495
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD064466L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018303020006
—
PA
Enumeration date
10/13/2005
Last updated
05/14/2008
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