Organization
DIVERSE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILU COSCOLLUELA (OWNER)
(973) 325-5768
Entity
Organization
Contact information
Practice address
515 VALLEY ST, SUITE 5, MAPLEWOOD, NJ 07040-1388
(973) 327-2471
(973) 327-2483
Mailing address
515 VALLEY ST, SUITE 5, MAPLEWOOD, NJ 07040-1388
(973) 327-2471
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/06/2011
Last updated
01/24/2017
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