Individual
DIANA MARIE FEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TEACHER
Contact information
Practice address
1071 LAKESHORE DR, MASSAPEQUA PARK, NY 11762-2411
(516) 205-2676
Mailing address
1071 LAKESHORE DR, MASSAPEQUA PARK, NY 11762-2411
(516) 205-2676
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1787775
NY
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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