DR. DIANE LOUISE FOUNTAS M.D. NPI 1376507301

NPI Information

NPI: 1376507301
Provider Name: DR. DIANE LOUISE FOUNTAS, M.D.
Classification: Pediatrics - 2080A0000X
Entity Type: Individual

Specialization: Adolescent Medicine

Address:
1389 W MAIN ST
SUITE 325
WATERBURY, CT
ZIP 06708
Phone: (203) 753-6776
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DR. Diane Louise Fountas, M.D. is an adolescent medicine pediatrics in Waterbury, CT. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. Diane Louise Fountas, M.D. NPI is 1376507301. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1389 W MAIN ST
SUITE 325
WATERBURY, CT
ZIP 06708-104
Phone: (203) 753-6776
Fax: (203) 573-1875

The enumeration date for this NPI number is 4/14/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080A0000X	Pediatrics	Adolescent Medicine	024436	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D83642	MEDICARE UPIN	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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