Provider Demographics
NPI:1902091564
Name:FIGUEREDO-DIETES, TATIANA (MD)
Entity type:Individual
Prefix:DR
First Name:TATIANA
Middle Name:
Last Name:FIGUEREDO-DIETES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TATIANA
Other - Middle Name:
Other - Last Name:FIGUEREDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:408 E 92ND ST APT 32F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6892
Mailing Address - Country:US
Mailing Address - Phone:570-205-0168
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-3917
Practice Address - Fax:212-263-8640
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432343207R00000X
NY316627-01207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine