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NPI Code Detail

MEDICARE: DARCEL DILLARD-SUITE

MEDICARE: DARCEL DILLARD-SUITE
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
1171400000XHealth & Wellness Coach

General Provider Information

NPI Number : 1922750074
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARCEL DILLARD-SUITE
Provider Business Mailing Address
First Line : 1136 NEILL AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-1328
Country : US
Telephone Number : 718-518-7600
Fax Number :
Provider Business Practice Location Address
First Line : 1136 NEILL AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-1328
Country : US
Telephone Number : 718-518-7600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2022
Last Update Date : 01/20/2022

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Directions to “ DARCEL DILLARD-SUITE ” Practice Location

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