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NPI Code Detail

MEDICARE: DARWIN ANTONIO MARIA LARA

MEDICARE: DARWIN ANTONIO MARIA LARA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1376001644
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARWIN ANTONIO MARIA LARA
Provider Business Mailing Address
First Line : 307 W 38TH ST FL 6
Second Line :
City : NEW YORK
State : NY
Zip : 10018-9537
Country : US
Telephone Number : 212-695-4564
Fax Number :
Provider Business Practice Location Address
First Line : 307 W 38TH ST FL 6
Second Line :
City : NEW YORK
State : NY
Zip : 10018-9537
Country : US
Telephone Number : 212-695-4564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2019
Last Update Date : 03/06/2019

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Directions to “ DARWIN ANTONIO MARIA LARA ” Practice Location

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