Active NPI
Elizabeth Diaz
- Speech-Language Pathologist
- Bronx, NY
National Provider Identifier
1407393473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 024606
- Practice address
- 1290 Spofford Ave
Bronx, NY 10474-6511 - Phone
- (718) 589-4312
- Fax
- (718) 842-6993
- NPI assigned
- Jan 27, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 024606 | NY | Primary |
Addresses
Primary practice location
1290 Spofford Ave
Bronx, NY 10474-6511
Mailing address
1290 Spofford Ave
Bronx, NY 10474-6511
Phone (718) 589-4312
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 |
|---|---|---|---|
| 024606 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485475200000",
"number": "1407393473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 SPOFFORD AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104746511",
"telephone_number": "718-589-4312",
"fax_number": "718-842-6993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1290 SPOFFORD AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104746511",
"telephone_number": "718-589-4312",
"fax_number": "718-842-6993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-27",
"last_updated": "2017-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "024606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.