Provider Demographics
NPI:1811258965
Name:HAAS, DIANA LUCIA (MS, ED)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:LUCIA
Last Name:HAAS
Suffix:
Gender:F
Credentials:MS, ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CRESTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1633
Mailing Address - Country:US
Mailing Address - Phone:516-837-9626
Mailing Address - Fax:516-837-9626
Practice Address - Street 1:1011 CRESTWOOD RD
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1633
Practice Address - Country:US
Practice Address - Phone:516-837-9626
Practice Address - Fax:516-837-9626
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421261031174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist