Individual
DANIELLE DIETZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
308 E 15TH ST # A, NEW YORK, NY 10003-4001
(212) 420-6460
Mailing address
301 E 78TH ST APT 9A, NEW YORK, NY 10075-1327
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
341510
NY
Other
Enumeration date
03/02/2018
Last updated
03/02/2018
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