Diaz, Agustin
Diaz, Agustin is an individual health care provider with primary practice located at 433 57Th St , West New York NJ 07093-2119. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Diaz, Agustin can be contacted via phone (201) 863-2620.Contact Information
Primary practice address
433 57Th St
West New York NJ 07093-2119
Phone: (201) 863-2620
Fax: (201) 863-4804
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MA58115 | New Jersey |
Profile Details
| NPI number | 1174582720 |
|---|---|
| LBN Legal business name | Diaz, Agustin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174582720 | NPPES |
| New Jersey | MEDICAID | 6428002 |
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