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Individual

DR. DARYL ISHAQ SHORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
462 1ST AVE, NBV 20N26, NEW YORK, NY 10016-9196
(212) 562-3697
Mailing address
462 1ST AVE, NEW YORK, NY 10016-9196

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
57.006050
OH
2084P0802X
Addiction Psychiatry Physician
Primary
244848
NY

Other

Enumeration date
04/16/2007
Last updated
05/09/2008
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