Provider Demographics
NPI:1528697828
Name:DIAZ GARCIA, MEMPHIS (MD)
Entity type:Individual
Prefix:
First Name:MEMPHIS
Middle Name:
Last Name:DIAZ GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 ADAMECS WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-3444
Mailing Address - Country:US
Mailing Address - Phone:215-327-1659
Mailing Address - Fax:
Practice Address - Street 1:205 LEXINGTON AVE FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6020
Practice Address - Country:US
Practice Address - Phone:212-335-0034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3297922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry