Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 155486 | NY |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 155486 | NY |
NPI | 1346222841 |
---|---|
Provider Name | Dr. Lawrence Neil Diamond |
First Address | Flushing, NY 11355-3433 |
Second Address | Flushing, NY 11355-3433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00963924 | (05) | NY |
A62583 | (02) | NY |