Provider Demographics
NPI:1447701073
Name:BEHRENS, DIANA MARIE
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:MARIE
Last Name:BEHRENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SADDLER CT
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4200
Mailing Address - Country:US
Mailing Address - Phone:631-338-0778
Mailing Address - Fax:
Practice Address - Street 1:3 SADDLER CT
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-4200
Practice Address - Country:US
Practice Address - Phone:631-549-8747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist