Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MD-440335 | PA |
NPI | 1023273919 |
---|---|
Provider Name | Thomas F Diaz |
First Address | Philadelphia, PA 19182-0933 |
Second Address | Flourtown, PA 19031-1644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2008 |
Last Update Date | 20/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1007278000 | MEDICAID TPI GROUP (01) | PA |
597586 | MEDICARE TPI GROUP (01) | PA |
CD4829 | RAILROAD MEDICARE TPI GROUP (01) | PA |