Individual
DR. RODOLFO DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1206 W SHERMAN AVE STE 2B, VINELAND, NJ 08360-6911
(856) 696-5510
(856) 696-5590
Mailing address
1206 W SHERMAN AVE, BLDG 2 SUITE B, VINELAND, NJ 08360-6916
(856) 696-5510
(856) 696-5590
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA04900200
NJ
207Y00000X
Otolaryngology Physician
Primary
25MA04900200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000270500
AMERICHOICE
NJ
01
—
1002541
RAILROAD MEDICARE
NJ
01
—
2025389
AETNA
NJ
05
—
5281300
—
NJ
01
—
AMERIHEALTH
0393811000
NJ
01
—
HORIZON NJ HEALTH
1079307
NJ
01
—
P387263
OXFORD
NJ
Enumeration date
03/15/2006
Last updated
03/24/2021
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