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NPI Code Detail

MEDICARE: MILES DONALD DIEVERT

MEDICARE: MILES DONALD DIEVERT
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
1235Z00000XSpeech-Language PathologistNY

General Provider Information

NPI Number : 1902759301
Entity Type Code : Individual
Provider Name (Legal Business Name) : MILES DONALD DIEVERT
Provider Business Mailing Address
First Line : 217 BURNS ST FL 3
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-6127
Country : US
Telephone Number : 718-451-5213
Fax Number :
Provider Business Practice Location Address
First Line : 475 E 57TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-6010
Country : US
Telephone Number : 718-451-5213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2026
Last Update Date : 02/17/2026

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Directions to “ MILES DONALD DIEVERT ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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