Individual
HECTOR DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
244 W 231ST ST, BRONX, NY 10463-5357
(718) 543-7777
(718) 543-7780
Mailing address
244 W 231ST ST, BRONX, NY 10463-5357
(718) 543-7777
(718) 543-7780
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03882079
—
NY
Enumeration date
09/15/2015
Last updated
06/20/2017
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