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General NPI Number Information
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NPI Number | 1942117858
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Entity Type | Individual
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Provider Name | AMARILIS KATYA DIEZ PRESILLA
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Gender | Female
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 377 JERSEY AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07302-4393
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Country | US
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Telephone | 201-915-2310
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 CENTRAL AVE
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City | UNION CITY
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State | NJ
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Zip | 07087-3215
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 26NJ15630300
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License Number State | NJ
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