Individual
MRS. DIANE ELIZABETH PRIMAVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
60 JEFFERSON ST, SUITE 1, MONTICELLO, NY 12701-1122
(845) 794-7897
(845) 794-1756
Mailing address
PO BOX 421, CRMC PHYSICIAN SERVICES, HARRIS, NY 12742-0421
(845) 794-9864
(845) 794-9868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
F333105
NY
363L00000X
Nurse Practitioner
F333105
NY
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
F333105
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02391293
—
NY
Enumeration date
09/27/2006
Last updated
03/04/2010
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