Provider Demographics
NPI:1619229820
Name:DIAZ, ARGELIA (NP)
Entity Type:Individual
Prefix:
First Name:ARGELIA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BRENTWOOD RD STE 2
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8022
Mailing Address - Country:US
Mailing Address - Phone:631-518-6040
Mailing Address - Fax:888-291-5798
Practice Address - Street 1:10 BRENTWOOD RD STE 2
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8022
Practice Address - Country:US
Practice Address - Phone:631-518-6040
Practice Address - Fax:631-518-6051
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306138-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health