Provider Demographics
NPI:1871933895
Name:DIEP, APRIL LYNN (DO)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:LYNN
Last Name:DIEP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:90 S MAIN ST
Mailing Address - Street 2:FAMILY RESIDENCY PROGRAM
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3649
Mailing Address - Country:US
Mailing Address - Phone:860-358-6300
Mailing Address - Fax:860-358-9249
Practice Address - Street 1:90 S MAIN ST
Practice Address - Street 2:FAMILY RESIDENCY PROGRAM
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3649
Practice Address - Country:US
Practice Address - Phone:860-358-6300
Practice Address - Fax:860-358-9249
Is Sole Proprietor?:No
Enumeration Date:2013-07-05
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT99999208M00000X
CT999999207Q00000X
CT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine