Individual
DIANE DECAROLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
605 GROVE ST, UNIT B1, CLIFTON, NJ 07013-3849
(917) 751-8700
Mailing address
605 GROVE ST, UNIT B1, CLIFTON, NJ 07013-3849
(917) 751-8700
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00585700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00475378
—
NY
Enumeration date
09/19/2008
Last updated
01/18/2016
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