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Contact Information

DIANA IMMENHAUSEN, DO
255 E OLD STURBRIDGE RD
BRIMFIELD, MA01010-9647
 Phone: 413-245-3389
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for DIANA IMMENHAUSEN · (Female)

NPI Number 1821331604
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/31/2013
Last updated 02/02/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 295025
  • NY License # 283013
Hospital affiliation(s)
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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