Healthcare Provider Details

I. General information

NPI: 1518214600
Provider Name (Legal Business Name): YAMILKA DE DIOS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 GRAND CONCOURSE
BRONX NY
10453-4303
US

IV. Provider business mailing address

2626 HALPERIN AVE
BRONX NY
10461-2631
US

V. Phone/Fax

Practice location:
  • Phone: 718-583-7736
  • Fax: 347-479-1303
Mailing address:
  • Phone: 718-618-0401
  • Fax: 347-479-1303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number086966
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number421940
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: