Basic Information
| Provider Information | |||||||||
| NPI: | 1700276680 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ALAVI | ||||||||
| FirstName: | DIANA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8900 VAN WYCK EXPY # 11418 | ||||||||
| Address2: | JAMAICA HOSPITAL MEDICAL CENTER | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114182832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182067708 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8900 VAN WYCK EXPY # 11418 | ||||||||
| Address2: | JAMAICA HOSPITAL MEDICAL CENTER | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114182832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182067708 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2015 | ||||||||
| LastUpdateDate: | 03/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 25MA09878900 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.