Individual
MS. DIANA PIVENSHTEYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 LAKESIDE PARK, SOUTHAMPTON, PA 18966-4078
(215) 768-9244
Mailing address
505 LAKESIDE PARK, SOUTHAMPTON, PA 18966-4078
(215) 768-9244
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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