Individual
DIANE DERMARDEROSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, HASBRO 122, PROVIDENCE, RI 02903-4923
(401) 444-6484
(401) 444-6378
Mailing address
26 GREENWOOD AVE, NEEDHAM, MA 02492-3402
(781) 710-8822
(781) 449-2492
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10774
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7010148
—
RI
Enumeration date
05/20/2006
Last updated
07/08/2007
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