Healthcare Provider Details

I. General information

NPI: 1497196133
Provider Name (Legal Business Name): MS. CHRISTINA MARIE DIAMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 BROADWAY 2-I
NEW YORK NY
10034-1602
US

IV. Provider business mailing address

5000 BROADWAY 2-I
NEW YORK NY
10034-1602
US

V. Phone/Fax

Practice location:
  • Phone: 646-708-4298
  • Fax:
Mailing address:
  • Phone: 646-708-4298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: