Healthcare Provider Details

I. General information

NPI: 1912534538
Provider Name (Legal Business Name): YASMEEN MOUSTAFA DARAZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W 57TH ST STE 1410
NEW YORK NY
10019-3227
US

IV. Provider business mailing address

200 W 57TH ST STE 1410
NEW YORK NY
10019-3227
US

V. Phone/Fax

Practice location:
  • Phone: 212-247-8100
  • Fax: 212-247-8093
Mailing address:
  • Phone: 212-247-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number342760
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: