Individual
DIANA VLAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(917) 587-1228
Mailing address
2384 36TH ST, ASTORIA, NY 11105-2213
(917) 587-1228
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
F340521
NY
282N00000X
General Acute Care Hospital
F340521
NY
363L00000X
Nurse Practitioner
340521
NY
Other
Enumeration date
12/04/2016
Last updated
02/14/2020
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