Whitaker, Diane L

Whitaker, Diane L is an individual health care provider with primary practice located at 263 Farmington Ave , Farmington CT 06030-0001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Whitaker, Diane L can be contacted via phone (860) 679-4600.

Contact Information

Primary practice address
263 Farmington Ave Farmington CT 06030-0001
Fax: (860) 679-1248
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 032383 Connecticut

Profile Details

NPI number 1124026398
LBN Legal business name Whitaker, Diane L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Jul 11th, 2022 - about 4 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 1124026398 NPPES
Connecticut MEDICAID 1323831

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