Individual
DIANA DOMINGO HEARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
222 CEDAR LN STE 207, TEANECK, NJ 07666-4312
(201) 833-7087
(201) 833-7123
Mailing address
222 CEDAR LN STE 207, TEANECK, NJ 07666-4312
(201) 833-7087
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
25MB10082700
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0739324
—
NJ
Enumeration date
05/02/2015
Last updated
07/05/2022
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