Healthcare Provider Details

I. General information

NPI: 1558578815
Provider Name (Legal Business Name): DARCIA BRYDEN-CURRIE RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LONG ISLAND COLLEGE HOSPITAL 339 HICKS STREET ATTN MERCEDES CRESPO
BROOKLYN NY
11201
US

IV. Provider business mailing address

4 HENRIETTA ST
VALLEY STREAM NY
11580-3121
US

V. Phone/Fax

Practice location:
  • Phone: 718-780-1832
  • Fax:
Mailing address:
  • Phone: 917-771-0426
  • Fax: 516-561-0319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number009891
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: