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General NPI Number Information
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NPI Number | 1982598082
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Entity Type | Individual
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Provider Name | MICHAEL A. DIAZ CASAC II
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Gender | Male
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2015 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10035-1015
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Country | US
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Telephone | 212-690-4625
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Fax |
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Provider Business Mailing Address
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Address Line | 21 BARTELS PL APT 3
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-6946
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Country | US
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Telephone | 914-278-0999
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 21473
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License Number State | NY
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