Healthcare Provider Details

I. General information

NPI: 1376527564
Provider Name (Legal Business Name): ELIZABETH DARZYNKIEWICZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 02/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1974 MAPLE HILL ST
YORKTOWN HEIGHTS NY
10598-4190
US

IV. Provider business mailing address

1974 MAPLE HILL ST
YORKTOWN HEIGHTS NY
10598-4190
US

V. Phone/Fax

Practice location:
  • Phone: 914-962-3815
  • Fax: 914-962-3821
Mailing address:
  • Phone: 914-962-3815
  • Fax: 914-962-3821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number136560
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2471B0102X
TaxonomyBone Densitometry Radiologic Technologist
License Number136560
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2471M2300X
TaxonomyMammography Radiologic Technologist
License Number136560
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number136560
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: