Basic Information
| Provider Information | |||||||||
| NPI: | 1407283963 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIAMOND | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | HARRIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 132 SAINT MARKS PL APT 2R | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112172071 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 348 13TH ST STE 203 | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112156179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187885101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2013 | ||||||||
| LastUpdateDate: | 10/08/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 090272 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.