Individual
CARMEN DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
66-88 MYRTLE AVENUE, GLENDALE, NY 11385
(718) 850-0440
Mailing address
6210 80TH RD, GLENDALE, NY 11385-6828
(347) 967-8486
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/20/2015
Last updated
07/20/2015
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