Individual
MS. DIANA ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
46 BAYARD ST, SUITE 405, NEW BRUNSWICK, NJ 08901-2152
(732) 247-1106
(732) 247-1124
Mailing address
134 EVERGREEN PLACE, 701, EAST ORANGE, NJ 07018
(973) 395-3701
(732) 247-1124
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA0601860
NJ
207R00000X
Internal Medicine Physician
25MA07628900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107140
—
NJ
01
—
116427
MEDICARE PROVIDER
NJ
Enumeration date
05/26/2006
Last updated
05/10/2008
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