Healthcare Provider Details

I. General information

NPI: 1437170594
Provider Name (Legal Business Name): DARIELLE D DARTT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E ADAMS ST
SYRACUSE NY
13210-2306
US

IV. Provider business mailing address

5784 WIDEWATERS PKWY STE 2
SYRACUSE NY
13214-1890
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-1871
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number263671
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: