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General NPI Number Information
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NPI Number | 1275333015
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Entity Type | Individual
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Provider Name | MS. MILDRED DIAZ
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Gender | Female
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 3708 91ST ST STE 3A
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7962
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Country | US
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Telephone | 718-779-2263
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Fax | 718-779-2225
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Provider Business Mailing Address
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Address Line | 212 W 129TH ST APT 11B
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City | NEW YORK
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State | NY
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Zip | 10027-1924
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Country | US
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Telephone | 347-326-2666
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Fax | 347-326-2666
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | NY
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