Joshua Diaz

Individual provider Active NPI Occupational Therapist · Williston Park, NY

NPI 1083168397 · NPPES record last updated Aug 4, 2016

Key facts

NPI
1083168397
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
018883 (NY)
Practice address
95 Custer Ave
Williston Park, NY 11596-2302
Phone
(516) 729-3353
NPI assigned
Aug 4, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
018883NYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 018883 NY Yes

Addresses

Primary practice location

95 Custer Ave
Williston Park, NY 11596-2302

Mailing address

95 Custer Ave
Williston Park, NY 11596-2302
Phone (516) 729-3353

Other providers in Williston Park, NY

All providers in Williston Park, NY · Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.