Mackenzie, Diane

Mackenzie, Diane is an individual health care provider with primary practice located at 495 N 13Th St , Newark NJ 07107-1317. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Mackenzie, Diane can be contacted via phone (973) 268-1400.

Contact Information

Primary practice address
495 N 13Th St Newark NJ 07107-1317
Phone: (973) 268-1400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 25MB07665200 New Jersey
Allopathic & Osteopathic Physicians / General Practice 208D00000X 25MB07665200 New Jersey

Profile Details

NPI number 1316931264
LBN Legal business name Mackenzie, Diane
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated May 7th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316931264 NPPES
New Jersey MEDICAID 0023361

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