Individual
JOSE JUAN DIAZ HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-7000
Mailing address
1510 LEXINGTON AVE APT 8B, NEW YORK, NY 10029-7159
(415) 407-6782
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
25MA09202800
NJ
2085R0204X
Vascular & Interventional Radiology Physician
260231
NY
Other
Enumeration date
10/12/2012
Last updated
10/12/2012
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