Provider Demographics
NPI:1063746014
Name:LARGOZA, DARO MENDOZA (MD)
Entity type:Individual
Prefix:DR
First Name:DARO
Middle Name:MENDOZA
Last Name:LARGOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MENDARO
Other - Middle Name:MENDOZA
Other - Last Name:LARGOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:50 W 34TH ST APT 15B10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3086
Mailing Address - Country:US
Mailing Address - Phone:347-526-1810
Mailing Address - Fax:
Practice Address - Street 1:50 WEST 34TH. ST.
Practice Address - Street 2:15B10
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2636
Practice Address - Country:US
Practice Address - Phone:347-526-1810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2269551744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study