Individual
JORGE L. DIEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
893 MAIN ST STE 202, EAST HARTFORD, CT 06108-2293
(860) 247-2137
(860) 728-0480
Mailing address
30 JORDAN LN, WETHERSFIELD, CT 06109-1278
(860) 263-0253
(860) 263-0262
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
042533
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001425330
—
CT
Enumeration date
05/23/2005
Last updated
06/18/2021
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