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NPI Code Detail

MEDICARE: VINCENT DARDEN LMSW

MEDICARE: VINCENT DARDEN LMSW
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
1104100000XSocial Worker094900NY

General Provider Information

NPI Number : 1437533437
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINCENT DARDEN LMSW
Provider Business Mailing Address
First Line : 600 S WILBUR AVE
Second Line :
City : SYRACUSE
State : NY
Zip : 13204-2730
Country : US
Telephone Number : 315-476-7441
Fax Number : 315-476-1582
Provider Business Practice Location Address
First Line : 600 S WILBUR AVE
Second Line :
City : SYRACUSE
State : NY
Zip : 13204-2730
Country : US
Telephone Number : 315-476-7441
Fax Number : 315-476-1582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2015
Last Update Date : 07/20/2015

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