National Provider Identifier
Diane Marie Moulton, MSED
Diane Marie Moulton, MSED is listed in the NPPES registry with a primary specialty of Specialist in Fairport, NY and a listed phone number of (585) 377-2230.
Profile Overview
- NPI
- 1053673061
- Provider Type
- Individual
- Primary Specialty
- Specialist
- Enumeration Date
- June 14, 2012
- Last Updated
- June 14, 2012
Practice Location
- 149 N Main St
- Fairport, NY 14450-1434
Phone: (585) 377-2230
Mailing Address
- 128 Woodbine Ave
- East Rochester, NY 14445-1823
Specialties
- Specialist (174400000X)
Full Record
- NPI
- 1053673061
- Entity Type
- Individual
- Last Name
- Moulton
- First Name
- Diane
- Middle Name
- Marie
- Credential
- MSED
- Mailing Street Address
- 128 Woodbine Ave
- Mailing City
- East Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14445-1823
- Mailing Country
- US
- Mailing Phone
- (585) 747-1417
- Practice Street Address
- 149 N Main St
- Practice City
- Fairport
- Practice State
- NY
- Practice ZIP Code
- 14450-1434
- Practice Country
- US
- Practice Phone
- (585) 377-2230
- Practice Fax
- (585) 377-2243
- Enumeration Date
- June 14, 2012
- Last Updated
- June 14, 2012
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Specialist (174400000X)