Provider Demographics
NPI:1659695229
Name:DAO, DIEM N (WHNP)
Entity Type:Individual
Prefix:
First Name:DIEM
Middle Name:N
Last Name:DAO
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 MADISON AVE
Mailing Address - Street 2:FLOOR 6
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7802
Mailing Address - Country:US
Mailing Address - Phone:212-554-2400
Mailing Address - Fax:646-312-0481
Practice Address - Street 1:94-98 MANHATTAN AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-2501
Practice Address - Country:US
Practice Address - Phone:718-388-0390
Practice Address - Fax:718-486-5741
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305078363LA2200X
NYF420914363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY331945Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification