Healthcare Provider Details

I. General information

NPI: 1063428787
Provider Name (Legal Business Name): DARIA YORK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 10/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 SOUTH ST
MORRISVILLE NY
13408-9671
US

IV. Provider business mailing address

PO BOX 1133
MORRISVILLE NY
13408-1133
US

V. Phone/Fax

Practice location:
  • Phone: 315-684-3117
  • Fax: 315-684-9848
Mailing address:
  • Phone: 315-684-3117
  • Fax: 315-684-9848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNJ00027600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF330704
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: