Basic Information
| Provider Information | |||||||||
| NPI: | 1235632373 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DIACONEASA | ||||||||
| FirstName: | DANIELA | ||||||||
| MiddleName: | CHRISTINA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RVS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1901 1ST AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100297404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124236271 | ||||||||
| FaxNumber: | 2124236692 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 1ST AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100297404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124236271 | ||||||||
| FaxNumber: | 2124236692 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2018 | ||||||||
| LastUpdateDate: | 03/15/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | 00060670 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.