Provider Demographics
NPI:1457756835
Name:LOPEZ-POSADAS, DIANA DIANA (MS,)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:DIANA
Last Name:LOPEZ-POSADAS
Suffix:
Gender:F
Credentials:MS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79-14 ROCKAWAY BEACH BLVD.
Mailing Address - Street 2:UNIT 1J
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11693-2579
Mailing Address - Country:US
Mailing Address - Phone:917-651-6410
Mailing Address - Fax:
Practice Address - Street 1:79-14 ROCKAWAY BEACH BLVD.
Practice Address - Street 2:UNIT 1J
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11693-2579
Practice Address - Country:US
Practice Address - Phone:917-651-6410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023607-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist