Provider Demographics
NPI:1992996516
Name:NZUZI, DIANGINDULA (LPN)
Entity type:Individual
Prefix:MISS
First Name:DIANGINDULA
Middle Name:
Last Name:NZUZI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97-05 HORACE HARDING EXPY
Mailing Address - Street 2:APT 1F
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368
Mailing Address - Country:US
Mailing Address - Phone:718-760-4027
Mailing Address - Fax:718-271-0685
Practice Address - Street 1:505 EAST 120TH STREET
Practice Address - Street 2:APT 6C
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10035
Practice Address - Country:US
Practice Address - Phone:212-410-7042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2368051164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02110694Medicaid