Provider Demographics
NPI:1861514911
Name:DIAS, MARIA A (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:DIAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 N COUNTRY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-1518
Mailing Address - Country:US
Mailing Address - Phone:631-331-8547
Mailing Address - Fax:631-476-0728
Practice Address - Street 1:28 N COUNTRY RD STE 101
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-1518
Practice Address - Country:US
Practice Address - Phone:631-331-8547
Practice Address - Fax:631-476-0728
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000920-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0102789OtherGHI-VALUE OPTIONS PIN#
NY073544OtherVALUE OPTIONS - LATHAM