Sergio Diaz Manzano, NURSE PRACTITIONER

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

310708 Issued in NY

Practice address

2575 36TH St Apt 2R
Astoria, NY 11103-4503

Phone

(347) 653-8560

NPI assigned

Apr 4, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1992446157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 36TH ST APT 2R",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034503",
            "telephone_number": "347-653-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 36TH ST APT 2R",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034503",
            "telephone_number": "347-653-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ MANZANO",
        "first_name": "SERGIO",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-04",
        "last_updated": "2022-04-04",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "NY",
            "license": "310708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "URL",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2575 36th St Apt 2R",
            "city": "Astoria",
            "state": "NY",
            "country_code": "US",
            "postal_code": "111034503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diabetic Care RX LLC
• Andrew Dorian Diakiwski, MA, MED
• Irene Diakogeorgios, BS
• Elisabeth Mary Diamantopoulos, PA-C
• Diamond Vision Corp
• Alexis Nicole Diaz, LCSW
• Melissa Diaz
• Yarisel Diaz, PSY.D
• Joseph Dibianco
• Virginia H Didonato, MA, BCC

• Adult Health Clinical Nurse Specialist in Astoria, NY
• Providers in Astoria, NY by specialty
• Adult Health Clinical Nurse Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.