Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 431805 | NY |
NPI | 1013523315 |
---|---|
Provider Name | Kayra Diaz |
First Address | New York, NY 10040-4411 |
Second Address | New York, NY 10065-6007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2020 |
Last Update Date | 01/11/2020 |