Individual
DIWARN SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1430 DORIS ST, APT 4 F, BRONX, NY 10462-4990
(718) 825-9900
Mailing address
1430 DORIS ST, APT 4 F, BRONX, NY 10462-4990
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
65006373
NY
Other
Enumeration date
07/12/2010
Last updated
07/12/2010
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