MEDICARE: MARGUERITE EUGENIE DIAB MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	201437	NY
2	2081P0004X	Spinal Cord Injury Medicine Physician	201437	NY

General Provider Information

NPI Number	:	1225093743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGUERITE EUGENIE DIAB MD

Provider Business Mailing Address
First Line	:	423 E 23RD ST
Second Line	:	DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION #117
City	:	NEW YORK
State	:	NY
Zip	:	10010-5011
Country	:	US
Telephone Number	:	212-686-7500
Fax Number	:	212-951-3246

Provider Business Practice Location Address
First Line	:	2600 NETHERLAND AVE
Second Line	:	APARTMENT # 1514
City	:	BRONX
State	:	NY
Zip	:	10463-4801
Country	:	US
Telephone Number	:	718-543-3553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	07/30/2010

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