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Diamond Maddox

Student in an Organized Health Care Education/Training Program in Arverne, NY. Individual provider (NPI-1).

NPI number1639972052
StatusActive
Last updated in NPPESMar 31, 2025

Details

NPI
1639972052
Entity type
Individual (NPI-1)
Name
Diamond Maddox
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 31, 2025
Certification date
Mar 31, 2025
Last updated
Mar 31, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

507 Beach 64th St
Arverne, NY 11692-1326

Phone 347-886-7321

Mailing address

507 Beach 64th St
Arverne, NY 11692-1326

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