Provider Demographics
NPI:1548149271
Name:DIAZ, FRANCISCO (LMT, BCTMB, CES)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:DIAZ
Suffix:
Gender:M
Credentials:LMT, BCTMB, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 BELL BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-1730
Mailing Address - Country:US
Mailing Address - Phone:718-775-2743
Mailing Address - Fax:
Practice Address - Street 1:2532 168TH ST STE 168
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1154
Practice Address - Country:US
Practice Address - Phone:718-775-2743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025905225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty