Active NPI
Crystal Lynn Diaz, OTR/L
- Occupational Therapist
- New York, NY
National Provider Identifier
1609166578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 021885
- Practice address
- 60 E 104TH St
3C
New York, NY 10029-4524 - Phone
- (212) 933-0820
- NPI assigned
- Apr 13, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 007835-1 | NY | |
| Occupational Therapist | 225X00000X | 021885 | NY | Primary |
Addresses
Primary practice location
60 E 104TH St
3C
New York, NY 10029-4524
Mailing address
340 Beach 102ND Street
Rockaway Park, NY 11694
Phone (570) 856-5953
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 |
|---|---|---|---|
| 007835-1 | NY | MD | Specialist |
| 021885 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505260800000",
"number": "1609166578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 BEACH 102ND STREET",
"city": "ROCKAWAY PARK",
"state": "NY",
"postal_code": "11694",
"telephone_number": "570-856-5953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 E 104TH ST",
"address_2": "3C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100294524",
"telephone_number": "212-933-0820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "CRYSTAL",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-13",
"last_updated": "2017-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "007835-1",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "NY",
"license": "021885",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.