| C Diaz Clinical Practice Corp | |
|
3045 Godwin Ter Apt 1d Bronx NY 10463-5341 | |
| (917) 573-9472 | |
| Not Available |
| Full Name | C Diaz Clinical Practice Corp |
|---|---|
| Speciality | Social Worker |
| Location | 3045 Godwin Ter Apt 1d, Bronx, New York |
| Authorized Official Name and Position | Claribel A Diaz (PRESIDENT) |
| Authorized Official Contact | 9175739472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C Diaz Clinical Practice Corp 3045 Godwin Ter Apt 1d Bronx NY 10463-5341 Ph: (917) 573-9472 | C Diaz Clinical Practice Corp 3045 Godwin Ter Apt 1d Bronx NY 10463-5341 Ph: (917) 573-9472 |
| NPI Number | 1134665425 |
|---|---|
| Provider Enumeration Date | 01/11/2017 |
| Last Update Date | 01/11/2017 |
| Medicare PECOS PAC ID | 3577848936 |
|---|---|
| Medicare Enrollment ID | O20170327001626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134665425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 082856 (New York) | Primary |
| Provider Name | Claribel A Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578652491 PECOS PAC ID: 7113247933 Enrollment ID: I20150519001671 |
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