Individual
MR. ANTHONY JAMES DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
711 PARK AVE, MEDINA, NY 14103
(585) 798-4344
(585) 798-0439
Mailing address
711 PARK AVE, MEDINA, NY 14103
(585) 798-4344
(585) 798-0439
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
020582
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00021030201
UNIVERA
—
01
—
000625923003
COMMUNITY BLUE
—
01
—
000625923004
COMMUNITY BLUE
—
01
—
00210030201
UNIVERA
—
01
—
0205821
LICENSE
—
05
—
02243158
—
NY
01
—
040511000802
FIDELIS
—
01
—
205707500
ACS DOL
—
01
—
7362441
AETNA
—
01
—
9310818
INDEPENDENT HEALTH
—
01
—
P010020582
RIPA
—
Enumeration date
06/21/2006
Last updated
12/03/2009
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