MEDICARE: DIANA NARANJO NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	308919	NY

General Provider Information

NPI Number	:	1376188177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA NARANJO NP

Provider Business Mailing Address
First Line	:	1610 OLD COUNTRY RD
Second Line	:
City	:	WESTBURY
State	:	NY
Zip	:	11590-5256
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1610 OLD COUNTRY RD
Second Line	:
City	:	WESTBURY
State	:	NY
Zip	:	11590-5256
Country	:	US
Telephone Number	:	516-228-4900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2019
Last Update Date	:	05/17/2023

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