Provider Demographics
NPI:1669891743
Name:HADE, DIANELA CAROLINA
Entity type:Individual
Prefix:
First Name:DIANELA
Middle Name:CAROLINA
Last Name:HADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DIANELA
Other - Middle Name:CAROLINA
Other - Last Name:FIRPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5552 NETHERLAND AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2376
Mailing Address - Country:US
Mailing Address - Phone:347-749-0460
Mailing Address - Fax:
Practice Address - Street 1:5552 NETHERLAND AVE APT 1A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2376
Practice Address - Country:US
Practice Address - Phone:347-749-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1199558174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist