Provider Demographics
NPI:1972509958
Name:DIAZ, FRANCISCO J (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:J
Last Name:DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:J
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12 LOGAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-1932
Mailing Address - Country:US
Mailing Address - Phone:201-463-1463
Mailing Address - Fax:
Practice Address - Street 1:391 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-1330
Practice Address - Country:US
Practice Address - Phone:201-858-4110
Practice Address - Fax:201-858-2240
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04136600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4972104Medicaid
NJ4972104Medicaid
511921Medicare ID - Type Unspecified