Provider Demographics
NPI:1083884761
Name:DIANA OQUENDO MD PLLC
Entity Type:Organization
Organization Name:DIANA OQUENDO MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:OQUENDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-524-9612
Mailing Address - Street 1:358 N BROADWAY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-2322
Mailing Address - Country:US
Mailing Address - Phone:914-524-9612
Mailing Address - Fax:914-524-9232
Practice Address - Street 1:358 N BROADWAY
Practice Address - Street 2:SUITE 202
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-2322
Practice Address - Country:US
Practice Address - Phone:914-524-9612
Practice Address - Fax:914-524-9232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151489207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty