Healthcare Provider Details

I. General information

NPI: 1558293936
Provider Name (Legal Business Name): DIANA M JUAREZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 MAIN ST E # 2ND
WEST HARRISON NY
10604-2756
US

IV. Provider business mailing address

507 MAIN ST E # 2ND
WEST HARRISON NY
10604-2756
US

V. Phone/Fax

Practice location:
  • Phone: 914-964-4444
  • Fax:
Mailing address:
  • Phone: 914-964-4444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number892230
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: