MEDICARE: DARREN BEDROSIAN LPSYA

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	102L00000X	Psychoanalyst	0009000	NY

General Provider Information

NPI Number	:	1972789931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARREN BEDROSIAN LPSYA

Provider Business Mailing Address
First Line	:	345 W 55TH ST
Second Line	:	1B
City	:	NEW YORK
State	:	NY
Zip	:	10019-4553
Country	:	US
Telephone Number	:	646-504-6434
Fax Number	:

Provider Business Practice Location Address
First Line	:	345 W 55TH ST
Second Line	:	1B
City	:	NEW YORK
State	:	NY
Zip	:	10019-4553
Country	:	US
Telephone Number	:	646-504-6434
Fax Number	:

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

Provider Enumeration Date	:	01/21/2008
Last Update Date	:	05/30/2013

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