Basic Information
Provider Information | |||||||||
NPI: | 1316314776 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | REMLINGER | ||||||||
FirstName: | DIANA | ||||||||
MiddleName: | D | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | PMHNP-BC, MSN | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 55 FOGG RD | ||||||||
Address2: |   | ||||||||
City: | WEYMOUTH | ||||||||
State: | MA | ||||||||
PostalCode: | 021902432 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7816248000 | ||||||||
FaxNumber: | 7818786750 | ||||||||
Practice Location | |||||||||
Address1: | 55 FOGG RD | ||||||||
Address2: |   | ||||||||
City: | WEYMOUTH | ||||||||
State: | MA | ||||||||
PostalCode: | 02190 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7816248000 | ||||||||
FaxNumber: | 7818786750 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/01/2015 | ||||||||
LastUpdateDate: | 11/07/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN 2299148 | MA | N |   | Nursing Service Providers | Registered Nurse |   | 207RA0401X | RN2299148 | MA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Addiction Medicine | 363LP0808X | RN2299148 | MA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.