Diana M Cipullo, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01586900 Issued in NJ

Practice address

725 NJ-15 #103
Lake Hopatcong, NJ 07849

Phone

(973) 288-9110

Fax

(973) 943-4838

NPI assigned

Nov 29, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Diana Berardi Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1437556909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "914-294-4586",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NJ-15 #103",
            "city": "LAKE HOPATCONG",
            "state": "NJ",
            "postal_code": "07849",
            "telephone_number": "973-288-9110",
            "fax_number": "973-943-4838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "459 Watchung Ave",
            "address_purpose": "LOCATION",
            "city": "Watchung",
            "state": "NJ",
            "postal_code": "070694945",
            "country_code": "US",
            "telephone_number": "908-756-2424",
            "fax_number": "908-756-2447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIPULLO",
        "first_name": "DIANA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-29",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01586900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "BERARDI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Lake Hopatcong, NJ
• Providers in Lake Hopatcong, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.