Healthcare Provider Details

I. General information

NPI: 1699312413
Provider Name (Legal Business Name): DARIEN RAGGOBEER NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2019
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 BROADWAY RM 502
NEW YORK NY
10038-4380
US

IV. Provider business mailing address

150 BROADWAY RM 502
NEW YORK NY
10038-4380
US

V. Phone/Fax

Practice location:
  • Phone: 845-279-5908
  • Fax:
Mailing address:
  • Phone: 845-279-5908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number780589
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number404610
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: