Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Diane Marie Moulton, MSED

Individual provider Specialist · NPI 1053673061

Diane Marie Moulton, MSED is a Specialist in Fairport, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2012
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Practice location Address checks out

149 N Main St
Fairport, NY 14450-1434
Phone: (585) 377-2230
Fax: (585) 377-2243
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 321126901 (NY)

Record details

NPI number1053673061
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSED
Sole proprietorYes
NPI enumeratedJune 14, 2012
Last updated in NPPESJune 14, 2012

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