Jennifer Marie Diaz
Pediatrician Allergist & Immunologist
1500 Route 112 Bldg. 4 - 2nd Floor
Port Jefferson Station
, New York 11776-8054
Jennifer Marie Diaz
Pediatrician Allergist & Immunologist
1500 Route 112 Bldg. 4 - 2nd Floor
Port Jefferson Station
, New York 11776-8054
(914) 984-2546
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About
Features
Specialties
- Allergist & Immunologist
- Pediatrician
Languages spoken
- English
Location
First Address
- Jennifer Marie Diaz
- 660 White Plains Rd Fl 4
- Tarrytown, NY
- Zip : 10591-5139
- Phone : (914) 984-2546
Second Address
- Jennifer Marie Diaz
- 1500 Route 112 Bldg. 4 - 2nd Floor
- Port Jefferson Station, NY
- Zip : 11776-8054
- Fax : (631) 928-0185
- Phone : (631) 828-7001
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207K00000X | Allergist & Immunologist | 251188 | NY |
| N | 208000000X | Pediatrician | 2511881 | NY |
National Provider Identifier
| NPI | 1053636431 |
|---|---|
| Provider Name | Jennifer Marie Diaz |
| First Address | Tarrytown, NY 10591-5139 |
| Second Address | Port Jefferson Station, NY 11776-8054 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/03/2010 |
| Last Update Date | 02/04/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| P01438980 | RAILROAD MEDICARE PIN (01) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.