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Individual

MRS. MICHELLE LEE DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, RD

Contact information

Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-7000
Mailing address
3 CENTURY DR, PARSIPPANY, NJ 07054-4610
(973) 251-1062

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
955344
NJ
146D00000X
Personal Emergency Response Attendant
Primary
25MP00338800
NJ
390200000X
Student in an Organized Health Care Education/Training Program
NJ

Other

Enumeration date
11/05/2007
Last updated
07/09/2014
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