Dr DIANA IMMENHAUSEN is a female medical professional, specializing in Family Medicine. She graduated in 2013 from Lake Erie College Of Osteopathic Medicine.
MEETING HOUSE LANE MEDICAL PRACTICE PC
3330 NOYAC RD
SAG HARBOR
NY
119631930
Tel: 6317252112
| Npi | 1821331604 |
| Pac Id | 9739473190 |
| Professional Enrollment Id | I20160808001164 |
| Last Name | IMMENHAUSEN |
| First Name | DIANA |
| Middle Name | |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | MEETING HOUSE LANE MEDICAL PRACTICE PC |
| Group Practice Pac Id | 6800972589 |
| Number Of Group Practice Members | 88 |
| Line 1 Street Address | 3330 NOYAC RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | SAG HARBOR |
| State | NY |
| Zip Code | 119631930 |
| Phone Number | 6317252112 |
| Hospital Affiliation Ccn 1 | 330393 |
| Hospital Affiliation Lbn 1 | SUNY/STONY BROOK UNIVERSITY HOSPITAL |
| Hospital Affiliation Ccn 2 | |
| Hospital Affiliation Lbn 2 | |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
Leave your comments, questions and feedback on this listing below. You can also correct any listing errors or omissions.