Provider Demographics
NPI:1487822623
Name:DIAZ, FRANKLIN (LPN)
Entity type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:
Last Name:DIAZ
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 DELAWARE AVE
Mailing Address - Street 2:#198
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-2606
Mailing Address - Country:US
Mailing Address - Phone:716-308-5649
Mailing Address - Fax:
Practice Address - Street 1:2316 DELAWARE AVE
Practice Address - Street 2:#198
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-2606
Practice Address - Country:US
Practice Address - Phone:716-308-5649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282368-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse