Diana Immenhausen (NPI# 1821331604, PAC ID# 9739473190) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1821331604 |
| PAC ID by PECOS | 9739473190 |
| Professional Enrollment ID | I20160808001164 |
| Full Name | Diana Immenhausen |
| Organization Legal Name | MEETING HOUSE LANE MEDICAL PRACTICE PC |
| Address |
3330 Noyac Rd Sag Harbor NY 11963-1930 |
| Phone Number | 6317252112 |
| Gender | F |
| Medical School | LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6800972589 |
| Number of Group Practice Members | 91 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330393 | SUNY/STONY BROOK UNIVERSITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3330 Noyac Rd, Sag Harbor, NY 11963-1930 | 6317252112 | MEETING HOUSE LANE MEDICAL PRACTICE PC |
| Organization Legal Name | MEETING HOUSE LANE MEDICAL PRACTICE PC |
| Physicians | 86 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly Britt | Nurse Practitioner | Meeting House Lane Medical Practice PC | 715 Roanoke Ave, Suite 7, Riverhead, NY 11901-2769 |
| Christopher Savarese | Nurse Practitioner | Meeting House Lane Medical Practice PC | 740 County Rd, 39a, Southampton, NY 11968-5247 |
| Biju Lukose | Family Medicine | Meeting House Lane Medical Practice PC | 470 Montauk Hwy, East Hampton, NY 11937 |
| Eugene Connolly | Physician Assistant | Meeting House Lane Medical Practice PC | 325 Meeting House Ln, Suite 403, Southampton, NY 11968-7000 |
| Steven B Sobey | Urology | Meeting House Lane Medical Practice PC | 117 Hampton Rd, Southampton, NY 11968-4923 |
| Aleksandra Liberman | Internal Medicine | Meeting House Lane Medical Practice PC | 182 W Montauk Hwy Bldg B, Suite H, Hampton Bays, NY 11946 |
| Steve K Georgopoulos | Gastroenterology | Meeting House Lane Medical Practice PC | 325 Meeting House Ln Bldg, 2 Suite 405, Southampton, NY 11968-5087 |
| Karen B Weisz | Nurse Practitioner | Meeting House Lane Medical Practice PC | 3330 Noyac Rd, Sag Harbor, NY 11963-1930 |
| Rene Molnar | Family Medicine | Meeting House Lane Medical Practice PC | 34 E Montauk Hwy, Suite 4, Hampton Bays, NY 11946-1866 |
| Damian A Marrese | Family Medicine | Meeting House Lane Medical Practice PC | 860 Montauk Hwy, Water Mill, NY 11976-2638 |
| Street Address |
3330 NOYAC RD |
| City | SAG HARBOR |
| State | NY |
| Zip | 11963-1930 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen B Weisz | Nurse Practitioner | Meeting House Lane Medical Practice PC | 3330 Noyac Rd, Sag Harbor, NY 11963-1930 |
| Elizabeth P White-fricker | Family Medicine | Meeting House Lane Medical Practice PC | 3330 Noyac Rd, Sag Harbor, NY 11963-1930 |
| Jason T Schwartz | Family Medicine | Meeting House Lane Medical Practice PC | 3330 Noyac Rd, Sag Harbor, NY 11963-1930 |
| Jill A Muse | Nurse Practitioner | Meeting House Lane Medical Practice PC | 3330 Noyac Rd, Sag Harbor, NY 11963-1930 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jo Anne Maynard | Nurse Practitioner | Mskcc Regional Network | 26 S Harbor Dr, North Haven, NY 11963-1215 |
| Mark A Halsey | Dermatology | 3350 Noyac Rd, Sag Harbor, NY 11963-1908 | |
| Catherine A Duffy | Occupational Therapy | Advanced Occupational Therapy Services, P.C. | 3330 Noyac Rd C, Sag Harbor, NY 11963-1931 |
| Richard Jay Richter | Podiatry | 3330 Noyac Rd Bldg B, Sag Harbor, NY 11963-1931 | |
| Molly A Piekut | Occupational Therapy | Advanced Occupational Therapy Services, P.C. | 3330 Noyac Rd C, Sag Harbor, NY 11963-1931 |
| Ellen Ruby | Clinical Social Worker | 26 Club Ln, Sag Harbor, NY 11963-2112 | |
| Susan A Penny | Clinical Social Worker | 15 Stoney Hill Rd, Sag Harbor, NY 11963-2700 | |
| Ilona K Polak | Family Medicine | 34 Bay St, Suite 103, Sag Harbor, NY 11963-3104 | |
| Suzanne J Kirby | Chiropractic | 34 Bay St, Sag Harbor, NY 11963-3104 | |
| George J Wilson | Physical Therapy | 34 Bay St, Suite 206, Sag Harbor, NY 11963-3104 | |
| Find all physicians in zip 11963 | |||
| City | SAG HARBOR |
| Zip Code | 11963 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | SAG HARBOR + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Diana Immenhausen.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.