Active NPI
Harrison Lee Diaz, L.P.N.
- Licensed Practical Nurse
- Suffern, NY
National Provider Identifier
1104308980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 321389
- Practice address
- 15 Suffern Place
Suffern, NY 10901 - Phone
- (845) 357-4500
- Fax
- (845) 357-5039
- NPI assigned
- Aug 29, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 321389 | NY | Primary |
Addresses
Primary practice location
15 Suffern Place
Suffern, NY 10901
Mailing address
15 Suffern Place
Suffern, NY 10901
Phone (845) 357-4500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 321389 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1104308980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 SUFFERN PLACE",
"city": "SUFFERN",
"state": "NY",
"postal_code": "10901",
"telephone_number": "845-357-4500",
"fax_number": "845-357-5039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 SUFFERN PLACE",
"city": "SUFFERN",
"state": "NY",
"postal_code": "10901",
"telephone_number": "845-357-4500",
"fax_number": "845-357-5039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "HARRISON",
"middle_name": "LEE",
"credential": "L.P.N.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-29",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "321389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffern, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.