Individual
SERGIO DIAZ MANZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
2575 36TH ST APT 2R, ASTORIA, NY 11103-4503
(347) 653-8560
Mailing address
2575 36TH ST APT 2R, ASTORIA, NY 11103-4503
(347) 653-8560
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
310708
NY
Other
Enumeration date
04/04/2022
Last updated
04/04/2022
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