Provider Demographics
NPI:1215184932
Name:DIEZ, CLAUDIA P (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:P
Last Name:DIEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 AMSTERDAM AVE
Mailing Address - Street 2:13TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1737
Mailing Address - Country:US
Mailing Address - Phone:212-744-8073
Mailing Address - Fax:
Practice Address - Street 1:1090 AMSTERDAM AVE
Practice Address - Street 2:13TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1737
Practice Address - Country:US
Practice Address - Phone:212-744-8073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2009-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017761103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300000187OtherMEDICARE PTAN