MEDICARE: DR. ERIC ALLEN DIAMOND M.D.

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	208800000X	Urology Physician	141261	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831118389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC ALLEN DIAMOND M.D.

Provider Business Mailing Address
First Line	:	1171 OLD COUNTRY RD
Second Line	:	SUITE # 5
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-5022
Country	:	US
Telephone Number	:	516-933-3323
Fax Number	:	516-938-7718

Provider Business Practice Location Address
First Line	:	1171 OLD COUNTRY RD
Second Line	:	SUITE # 5
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-5022
Country	:	US
Telephone Number	:	516-933-3323
Fax Number	:	516-938-7718

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	10/31/2010

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