Individual
NICOLE THERESA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
26901 76TH AVE, ROOM 173, NEW HYDE PARK, NY 11040-1433
(718) 470-3937
Mailing address
26901 76TH AVE, ROOM 173, NEW HYDE PARK, NY 11040-1433
(718) 470-3937
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
22 543334
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
38 382016
NY
Other
Enumeration date
01/29/2009
Last updated
04/25/2016
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