Most Relevant Information
Provider Data
NPI Number: | 1003290099 |
Provider Name: | CARMEN DIAZ M.A. |
Entity Type: | Individual |
Taxonomy Code: | 171W00000X |
Specialty: | Contractor |
License Number: |
Most Important Dates
Enumeration Date: | 07/20/2015 |
Last Updated: | 07/20/2015 |
Provider Practice Location
66-88 MYRTLE AVENUE
GLENDALE
NY
11385
Practice Location Phone/Fax
Phone: | 7188500440 |
Fax: |
Provider Mailing Location
6210 80TH RD
GLENDALE
NY
113856828
Provider Mailing Phone/Fax
Phone: | 3479678486 |
Fax: |