Provider Demographics
NPI:1528892155
Name:BUELE CALLE, DIANA ESTEFANIA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:ESTEFANIA
Last Name:BUELE CALLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7814 46TH AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2929
Mailing Address - Country:US
Mailing Address - Phone:347-479-7699
Mailing Address - Fax:
Practice Address - Street 1:7814 46TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-2929
Practice Address - Country:US
Practice Address - Phone:347-479-7699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician