Individual
JACOB DARER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 WRIGHT AVENUE, MARCY, NY 13404
(315) 736-8271
Mailing address
8 PEPPERIDGE LN, WHITE PLAINS, NY 10605-4453
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
137078
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137078
—
NY
Enumeration date
06/05/2007
Last updated
07/08/2007
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