MEDICARE: DR. DARIAN ANDREAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208800000X	Urology Physician	31712901	NY

General Provider Information

NPI Number	:	1184157919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARIAN ANDREAS MD

Provider Business Mailing Address
First Line	:	4701 QUEENS BLVD STE 101
Second Line	:
City	:	SUNNYSIDE
State	:	NY
Zip	:	11104-1660
Country	:	US
Telephone Number	:	929-483-2030
Fax Number	:	917-832-6768

Provider Business Practice Location Address
First Line	:	4701 QUEENS BLVD STE 101
Second Line	:
City	:	SUNNYSIDE
State	:	NY
Zip	:	11104-1660
Country	:	US
Telephone Number	:	929-483-2030
Fax Number	:	917-832-6768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2017
Last Update Date	:	06/30/2022

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