Provider Demographics
NPI:1073704458
Name:DIAMOND, JASON BRETT (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:BRETT
Last Name:DIAMOND
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Gender:M
Credentials:MD, MPH
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Other - First Name:
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Mailing Address - Street 1:5141 BROADWAY
Mailing Address - Street 2:3RE SUITE 261
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1159
Mailing Address - Country:US
Mailing Address - Phone:212-932-4254
Mailing Address - Fax:212-932-4873
Practice Address - Street 1:5141 BROADWAY
Practice Address - Street 2:3RE SUITE 261
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1159
Practice Address - Country:US
Practice Address - Phone:212-932-4254
Practice Address - Fax:212-932-4873
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2013-03-18
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Provider Licenses
StateLicense IDTaxonomies
NY2615492084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology