Provider Demographics
NPI:1205807948
Name:PSYRRI, DIAMANDO (MD)
Entity type:Individual
Prefix:
First Name:DIAMANDO
Middle Name:
Last Name:PSYRRI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HOWARD AVE
Mailing Address - Street 2:YALE PHYSICIAN'S BUILDING - 2ND FLOOR
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1369
Mailing Address - Country:US
Mailing Address - Phone:203-785-6884
Mailing Address - Fax:203-737-2617
Practice Address - Street 1:800 HOWARD AVE
Practice Address - Street 2:YALE PHYSICIAN'S BUILDING - 2ND FLOOR
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-6884
Practice Address - Fax:203-737-2617
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT040800207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001408005Medicaid
CT001408005Medicaid
CT830000123Medicare ID - Type Unspecified