Individual
DR. DIEGO ANDRES PONIEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 W 110TH ST, NEW YORK, NY 10026-4281
(212) 865-2740
(212) 537-6414
Mailing address
111 W 110TH ST, NEW YORK, NY 10026-4281
(212) 865-2740
(212) 537-6414
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
236424
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02661916
—
NY
Enumeration date
04/14/2006
Last updated
04/06/2023
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