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General NPI Number Information
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NPI Number | 1619946480
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Entity Type | Individual
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Provider Name | DARRIN WILLIAM GERSON PSYD
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Gender | Male
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 75 PROSPECT ST SUITE 206
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City | HUNTINGTON
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State | NY
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Zip | 11743-3382
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Country | US
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Telephone | 516-314-0251
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Fax |
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Provider Business Mailing Address
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Address Line | 26 JOHN DR
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City | OLD BETHPAGE
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State | NY
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Zip | 11804-1541
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Country | US
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Telephone | 516-454-7584
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 016157
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License Number State | NY
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