Look up the most recent NPI and PECOS records

Jennifer Diaz

Licensed Practical Nurse

Nursing Service Providers

2429 Culver Rd, Rochester, NY 14609-1745

PECOS Enrollment

Based on the most recent information from CMS, provider Jennifer Diaz does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:33 PM.

Profile Details

Provider ID
1669730792
Provider Type
Individual
Full Name
Diaz, Jennifer
Credential
LPN

Gender
Female
Sole Proprietor
Yes
Enumeration Date
4/26/2012
Last Updated
8/12/2022

Contact Information

Practice Location

2429 Culver Rd, Rochester, NY 14609-1745

(585) 755-8494

Unlisted Fax

Mailing Location

2429 Culver Rd, Rochester, NY 14609-1745

(585) 755-8494

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 164W00000X Primary	Description Licensed Practical Nurse Nursing Service Providers	License 309206 New York

Provider Identifiers

ID	Description	Issuer
ID 1669730792	Description Medicaid	Issuer Unlisted New York

Jennifer Diaz

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Colon, Phalon M

Gourdine, Allison

Gillon, Leandra

Forest, Allie Caren

Young, Janet E

Dennis, Pretoria Shaneen

Smith, Katherine Zephania

Gulisano, Lori Ann

Difiore, Shanyc

Jennings, Inel