Provider Demographics
NPI:1063428787
Name:YORK, DARIA (APRN)
Entity type:Individual
Prefix:
First Name:DARIA
Middle Name:
Last Name:YORK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1133
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13408-1133
Mailing Address - Country:US
Mailing Address - Phone:315-684-3117
Mailing Address - Fax:315-684-9848
Practice Address - Street 1:3460 SOUTH ST
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NY
Practice Address - Zip Code:13408-9671
Practice Address - Country:US
Practice Address - Phone:315-684-3117
Practice Address - Fax:315-684-9848
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ00027600363LF0000X
NYF330704363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400068603Medicare PIN
NJ069027Medicare ID - Type Unspecified