Individual
ROSADEL DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12385
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004002358
—
CT
01
—
C00123
MEDICARE UPIN
CT
Enumeration date
08/16/2019
Last updated
08/16/2019
Update your record
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