Individual
DR. VLAD DIACONITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
635 W 165TH ST, NEW YORK, NY 10032-3724
(212) 305-9535
(212) 342-5293
Mailing address
635 W 165TH ST, NEW YORK, NY 10032-3724
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
297493
NY
207W00000X
Ophthalmology Physician
63939
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
297493
NY STATE LICENSE
NY
Enumeration date
05/23/2019
Last updated
10/04/2022
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