Individual
MS. DIANE TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00767300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2308875
UNITED HEALTHCARE
NJ
01
—
2K6509
HEALTH NET
NJ
01
—
3170904
AETNA HMO
NJ
01
—
7104649
CIGNA
NJ
01
—
P3424157
AETNA OPEN ACCESS
NJ
01
—
P3592053
OXFORD FREEDOM PLAN
NJ
Enumeration date
07/11/2006
Last updated
07/08/2007
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