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Individual

DR. DIANA MARCELA PAEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
263 FARMINGTON AVE, PSYCHIATRY OFFICE, FARMINGTON, CT 06030-1410
(860) 679-6700
(860) 679-6736
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT OFFICE, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610

Taxonomy

Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
Primary
050224
CT
2084P0800X
Psychiatry Physician
050224
CT

Other

Enumeration date
08/20/2007
Last updated
06/19/2012
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