Individual
ARDALIS DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9026 218TH PL, QUEENS VILLAGE, NY 11428-1337
(718) 264-7250
(718) 264-7922
Mailing address
9026 218TH PL, QUEENS VILLAGE, NY 11428-1337
(718) 264-7250
(718) 264-7922
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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