Individual
JOSEPHINE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
162 MOUNTAIN RD, SUFFIELD, CT 06078-2091
(860) 668-1211
(860) 668-2045
Mailing address
37 HARMONY HILL RD, GRANBY, CT 06035-1222
(860) 668-1211
(860) 668-7728
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000895
CT
Other
Enumeration date
07/27/2006
Last updated
08/31/2012
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