Individual
MS. KATELYN DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
1301 5TH AVE, NEW YORK, NY 10029-3119
(212) 426-3400
Mailing address
645 W 239TH ST, 3E, BRONX, NY 10463-1234
(718) 578-7019
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1676482
NY
Other
Enumeration date
06/08/2012
Last updated
06/08/2012
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