Individual
DANIEL MICHAEL DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(516) 673-1408
Mailing address
119 INTERVALE AVE, FARMINGDALE, NY 11735-5830
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
674998
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
151336
NY
Other
Enumeration date
05/21/2024
Last updated
10/29/2024
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