Provider Demographics
NPI:1437416344
Name:BARAYEVA, DIANA (DO)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:BARAYEVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6441 SAUNDERS ST
Mailing Address - Street 2:APT 306
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3248
Mailing Address - Country:US
Mailing Address - Phone:646-413-0553
Mailing Address - Fax:
Practice Address - Street 1:6441 SAUNDERS ST
Practice Address - Street 2:APT 306
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3248
Practice Address - Country:US
Practice Address - Phone:646-413-0553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY284053208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation