Individual
LOUIS DIAMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
19 S WASHINGTON AVE, BERGENFIELD, NJ 07621-2324
(201) 387-0177
Mailing address
10912 LA SALINAS CIR, BOCA RATON, FL 33428-1237
(561) 239-3436
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00456500
NJ
363A00000X
Physician Assistant
Primary
PA9113658
FL
Other
Enumeration date
11/28/2017
Last updated
07/27/2021
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