Provider Demographics
NPI:1861937575
Name:DIAZ MARTINEZ, ANEURY A (MD)
Entity type:Individual
Prefix:DR
First Name:ANEURY
Middle Name:A
Last Name:DIAZ MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ANEURY
Other - Middle Name:A
Other - Last Name:DIAZ MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:135 TERRACE VIEW AVE
Mailing Address - Street 2:APT 3C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5011
Mailing Address - Country:US
Mailing Address - Phone:347-569-1329
Mailing Address - Fax:
Practice Address - Street 1:135 TERRACE VIEW AVE
Practice Address - Street 2:APT 3C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-5011
Practice Address - Country:US
Practice Address - Phone:347-569-1329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-04
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16-788246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant