Individual
MR. EDWIN MANUEL DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
140 N BICYCLE PATH, SELDEN, NY 11784-2287
(631) 846-9137
Mailing address
140 N BICYCLE PATH, SELDEN, NY 11784-2287
(631) 846-9137
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0095911
NY
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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