| Doctor Name: | JOSEPHINE DIAZ |
| NPI Number: | 1871517342 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 000895 |
| Business Practice Address: | 162 Mountain Rd Suffield, CT - 060782091 |
| Business Phone Number: | 8606681211 |
| Business Fax Number: | 8606682045 |
| Mailing Address: | 37 Harmony Hill Rd, GRANBY |
| State: | CT |
| Postal Code: | 060351222 |
| Phone Number: | 8606681211 |
| Fax Number: | 8606687728 |
| NPI Enumeration Date: | 07/27/2006 |
| NPI Last Update Date: | 08/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 000895 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |