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General NPI Number Information
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NPI Number | 1962630624
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Entity Type | Individual
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Provider Name | DARCY ERIN BROUGHEL-BAER D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 102 BRADHURST AVE APT 1101
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City | NEW YORK
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State | NY
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Zip | 10039-3305
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Country | US
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Telephone | 347-726-8738
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Fax |
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Provider Business Mailing Address
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Address Line | 102 BRADHURST AVE APT 1101
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City | NEW YORK
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State | NY
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Zip | 10039-3305
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Country | US
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Telephone | 347-726-8738
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 252204
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License Number State | NY
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