Provider Demographics
NPI:1033715396
Name:MORRIS, DIAMONIQUE
Entity Type:Individual
Prefix:
First Name:DIAMONIQUE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 E POST RD APT 2B
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4622
Mailing Address - Country:US
Mailing Address - Phone:914-522-1977
Mailing Address - Fax:
Practice Address - Street 1:66 E POST RD APT 2B
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4622
Practice Address - Country:US
Practice Address - Phone:914-522-1977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYK1007555202Medicaid