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Individual

JOSE DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
545 1ST AVE, GREENBERG HALL, SUITE C-124, NEW YORK, NY 10016-6401
(646) 501-4266
Mailing address
545 1ST AVE, GREENBERG HALL, SUITE C-124, NEW YORK, NY 10016-6401

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
649797
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
430920
NY

Other

Enumeration date
11/18/2014
Last updated
11/01/2015
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