Provider Demographics
NPI:1932966371
Name:DIAMANTIS-SVEC, ATHANASIA TANYA (CLC)
Entity Type:Individual
Prefix:
First Name:ATHANASIA
Middle Name:TANYA
Last Name:DIAMANTIS-SVEC
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1006
Mailing Address - Country:US
Mailing Address - Phone:516-698-2111
Mailing Address - Fax:
Practice Address - Street 1:598 9TH ST
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1006
Practice Address - Country:US
Practice Address - Phone:516-698-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty