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General NPI Number Information
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NPI Number | 1811613433
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Entity Type | Individual
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Provider Name | MR. DARIUS II LAZARO OPADA
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Gender | Male
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 45 LUDLOW ST STE 402
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City | YONKERS
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State | NY
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Zip | 10705-1949
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Country | US
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Telephone | 347-667-7924
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Fax | 332-262-2396
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Provider Business Mailing Address
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Address Line | 417 FOOTHILLS PKWY NE # 417
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City | GAINESVILLE
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State | GA
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Zip | 30501-3840
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Country | US
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Telephone | 615-594-6940
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN291021
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 406781
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License Number State | NY
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