Individual
MR. OLIVER SALCEDO DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(646) 317-4570
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-6345
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
430373
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D40286038210692
DRIVER LICENSE
NJ
Enumeration date
12/13/2007
Last updated
03/18/2023
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