Provider Demographics
NPI:1609021963
Name:DIETRICH, JANET M (RN)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:M
Last Name:DIETRICH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-2405
Mailing Address - Country:US
Mailing Address - Phone:845-638-4885
Mailing Address - Fax:
Practice Address - Street 1:5 HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-2405
Practice Address - Country:US
Practice Address - Phone:845-638-4885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-28
Last Update Date:2008-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY359130163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics