Healthcare Provider Details
I. General information
NPI: 1861606014
Provider Name (Legal Business Name): DIOGENES ANTIPAS ALMONTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/09/2007
Last Update Date: 12/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
608 GRAND STREET
BROOKLYN NY
11211
US
IV. Provider business mailing address
381 5TH ST
BROOKLYN NY
11215-2806
US
V. Phone/Fax
- Phone: 718-388-8400
- Fax: 718-486-0277
- Phone: 718-852-5252
- Fax: 718-802-1113
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 123004 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: