Provider Demographics
NPI:1972300119
Name:CARDENAS MARTINEZ, DIANA LIZETH
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:LIZETH
Last Name:CARDENAS MARTINEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WILDER ST APT A18
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-2551
Mailing Address - Country:US
Mailing Address - Phone:267-414-9135
Mailing Address - Fax:
Practice Address - Street 1:25 WILDER ST APT A18
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-2551
Practice Address - Country:US
Practice Address - Phone:267-414-9135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY94300901163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse