Individual
CARL DIAZ-PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
711 TROY SCHENECTADY RD STE 119, LATHAM, NY 12110-2454
(518) 786-9131
(518) 786-9136
Mailing address
711 TROY SCHENECTADY RD, SUITE 201, LATHAM, NY 12110-2442
(518) 782-3700
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
007208
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02340825
—
NY
Enumeration date
10/16/2006
Last updated
04/16/2021
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