| Dr. Diane Simmons L.l.c. | |
|
85 Raritan Ave Ste 420 Highland Park NJ 08904-2439 | |
| (732) 692-7348 | |
| Not Available |
| Full Name | Dr. Diane Simmons L.l.c. |
|---|---|
| Speciality | Psychologist |
| Location | 85 Raritan Ave Ste 420, Highland Park, New Jersey |
| Authorized Official Name and Position | Diane Simmons (OWNER) |
| Authorized Official Contact | 7326927348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Diane Simmons L.l.c. 85 Raritan Ave Ste 420 Highland Park NJ 08904-2439 Ph: (732) 692-7348 | Dr. Diane Simmons L.l.c. 85 Raritan Ave Ste 420 Highland Park NJ 08904-2439 Ph: (732) 692-7348 |
| NPI Number | 1346807864 |
|---|---|
| Provider Enumeration Date | 05/20/2019 |
| Last Update Date | 05/20/2019 |
| Medicare PECOS PAC ID | 6305171984 |
|---|---|
| Medicare Enrollment ID | O20190718002679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346807864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Diane Octavia Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760719504 PECOS PAC ID: 7113252792 Enrollment ID: I20190718002794 |
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