Individual
DIANA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1331 E WYOMING AVE, SUITE 4120, PHILADELPHIA, PA 19124-3808
(215) 831-1170
(215) 744-7394
Mailing address
2 W 10TH ST, MARCUS HOOK, PA 19061-4513
(610) 859-8850
(610) 859-7876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
J10002489
DE
225100000X
Physical Therapist
Primary
PT-20449
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102466580-0001
—
PA
01
—
1326372996
DPCI
DE
01
—
2140245
PA BLUE SHIELD
PA
01
—
299173
UNISON
—
01
—
30080473
KEYSTONE MERCY
PA
01
—
3746089000
IBC
DE
Enumeration date
09/29/2009
Last updated
02/02/2011
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