Provider Demographics
NPI:1902195399
Name:DIAS, YVONNE CLAUDIA
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:CLAUDIA
Last Name:DIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 LEIGHTON RD
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3515
Mailing Address - Country:US
Mailing Address - Phone:646-529-1608
Mailing Address - Fax:516-437-0741
Practice Address - Street 1:2214 LEIGHTON ROOD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003
Practice Address - Country:US
Practice Address - Phone:646-529-1608
Practice Address - Fax:516-437-0741
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4885051163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse