Diane Dettmore, | |
1340 Hamburg Tpke, Wayne, NJ 07470-4003 | |
(973) 633-1996 | |
Not Available |
Full Name | Diane Dettmore |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 11 Years |
Location | 1340 Hamburg Tpke, Wayne, New Jersey |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285045757 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 26NJ00456900 (New Jersey) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Kashoqa Psychiatry Associates Pc | 8921279472 | 3 |
Entity Name | Kashoqa Psychiatry Associates Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568539203 PECOS PAC ID: 8921279472 Enrollment ID: O20110914000343 |
Mailing Address | Practice Location Address |
---|---|
Diane Dettmore, 57 Montross Ave, Rutherford, NJ 07070-1147 Ph: (551) 206-9812 | Diane Dettmore, 1340 Hamburg Tpke, Wayne, NJ 07470-4003 Ph: (973) 633-1996 |
Cecilia Ezuduemoih, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1501 Hamburg Tpke, Wayne, NJ 07470 Phone: 862-684-8484 | |
Mrs. Deanna Marie Sanacore, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 342 Hamburg Tpke Ste 107, Wayne, NJ 07470 Phone: 973-870-0777 Fax: 888-465-2135 | |
Yelena Anfibio, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 506 Hamburg Tpke Ste 202, Wayne, NJ 07470 Phone: 973-595-1809 | |
Jacquelyn Marie Amodeo, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 246 Hamburg Tpke Ste 205, Wayne, NJ 07470 Phone: 973-389-1800 | |
Tangina B Rahman, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15 Vizcaya Ct, Wayne, NJ 07470 Phone: 973-870-8744 | |
Se Young Oh, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1680 State Route 23 Ste 250, Wayne, NJ 07470 Phone: 973-633-1122 Fax: 973-832-7550 | |
Hamida 0 Yaqoobi, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2440 Hamburg Tpke, Wayne, NJ 07470 Phone: 973-839-3400 |