Individual
CHRISTINA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1107 VILLAGE DR APT A, RIDGE, NY 11961-8305
(631) 946-0646
Mailing address
1107 VILLAGE DR APT A, RIDGE, NY 11961-8305
(631) 946-0646
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303860-1
NY
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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