Provider Demographics
NPI:1407328438
Name:DIAZ, RAYMOND (MA, MM, MS)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MA, MM, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W 181ST ST APT 46
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4549
Mailing Address - Country:US
Mailing Address - Phone:914-391-6086
Mailing Address - Fax:
Practice Address - Street 1:801 W 181ST ST APT 46
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4549
Practice Address - Country:US
Practice Address - Phone:914-391-6086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist