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General NPI Number Information
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NPI Number | 1780567974
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Entity Type | Individual
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Provider Name | KAYLA DARIENZO FNP
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Gender | Female
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1991 MARCUS AVE STE M100
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-2062
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Country | US
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Telephone | 516-472-3650
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Fax |
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Provider Business Mailing Address
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Address Line | 1116 5TH AVE
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-2532
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Country | US
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Telephone | 631-741-4114
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 357282
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License Number State | NY
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