Individual
DIANA PATRICIA POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2015 GRAND CONCOURSE, BRONX, NY 10453-4303
(718) 299-7295
(718) 299-6797
Mailing address
1434 WILLIAMSBRIDGE RD FL 2, BRONX, NY 10461-2507
(718) 618-0401
(516) 483-3794
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
618692
NY
363LF0000X
Family Nurse Practitioner
Primary
338120
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03194332
—
NY
01
—
G400355610
MEDICARE
NY
Enumeration date
03/06/2010
Last updated
04/07/2021
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