Doctor Name: | MRS. LORRAINE M DIAZ |
NPI Number: | 1528148244 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RPT |
License Number: | 002268 |
Business Practice Address: | 121 Wakelee Ave Ansonia, CT - 064011198 |
Business Phone Number: | 2037361020 |
Business Fax Number: | 2037361022 |
Mailing Address: | 111 Wakelee Ave, ANSONIA |
State: | CT |
Postal Code: | 064011151 |
Phone Number: | 2037347900 |
Fax Number: | 2037361076 |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 002268 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |