Individual
MS. CARLA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 ORVILLE DR STE 100, BOHEMIA, NY 11716-2505
(631) 124-4143
(631) 536-2238
Mailing address
80 ORVILLE DR STE 100, BOHEMIA, NY 11716-2505
(631) 244-1436
(631) 536-2238
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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