Lorraine Marie Diaz, L.P.N.

Individual provider Active NPI Licensed Practical Nurse · Roosevelt, NY

NPI 1457683096 · NPPES record last updated Feb 8, 2010

Key facts

NPI
1457683096
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
221389-1 (NY)
Practice address
380 Washington Avenue
United Cerebral Palsy
Roosevelt, NY 11757
Phone
(516) 378-2000
Fax
(516) 377-2081
NPI assigned
Feb 8, 2010
Sex
Female
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
221389-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 221389-1 NY Yes

Addresses

Primary practice location

380 Washington Avenue
United Cerebral Palsy
Roosevelt, NY 11757

Mailing address

380 Washington Avenue
United Cerebral Palsy
Roosevelt, NY 11575
Phone (516) 378-2000

Other providers in Roosevelt, NY

All providers in Roosevelt, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.