Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 25MA0693000 | NJ |
NPI | 1992862585 |
---|---|
Provider Name | Dr. Rowen Gumpas Diano |
First Address | Boston, MA 02241-9430 |
Second Address | Montclair, NJ 07042-3411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 01/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G93460 | (02) | NJ |