Individual
CHARLENE DIEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
123 BEACH 60TH ST, ARVERNE, NY 11692-1849
(718) 318-0447
Mailing address
123 BEACH 60TH ST, ARVERNE, NY 11692-1849
(718) 318-0447
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
286757
NY
Other
Enumeration date
12/22/2009
Last updated
12/22/2009
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