Provider Demographics
NPI:1922728294
Name:DIAZ, RASHELLE
Entity Type:Individual
Prefix:MS
First Name:RASHELLE
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159-16 UNION TURNPIKE
Mailing Address - Street 2:SUITE 325, FRESH MEADOWS, NY 11366-1963
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11366
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:159-16 UNION TURNPIKE, SUITE 325
Practice Address - Street 2:FRESH MEADOWS, NY 11366-1963
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11366
Practice Address - Country:US
Practice Address - Phone:718-267-5441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator