Individual
MS. DIANE M SCALISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1450 CHAMPLIN AVE, UTICA, NY 13502-3662
(615) 624-9000
Mailing address
10615 DOYLE RD, DEERFIELD, NY 13502-6809
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
301408
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02328581
—
NY
Enumeration date
11/02/2005
Last updated
02/27/2020
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