Provider Demographics
NPI:1265017156
Name:WASHINGTON, DARRYL LLAMONT
Entity Type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:LLAMONT
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 W 166TH ST APT 5F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4446
Mailing Address - Country:US
Mailing Address - Phone:347-478-2848
Mailing Address - Fax:
Practice Address - Street 1:465 W 166TH ST APT 5F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4446
Practice Address - Country:US
Practice Address - Phone:212-283-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst