Provider Demographics
NPI:1407809312
Name:ROHAN, DARREN I (MD)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:I
Last Name:ROHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:117 MARYS AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-5849
Mailing Address - Country:US
Mailing Address - Phone:845-331-1235
Mailing Address - Fax:845-331-1262
Practice Address - Street 1:117 MARYS AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-5849
Practice Address - Country:US
Practice Address - Phone:845-331-1235
Practice Address - Fax:845-331-1262
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227760208G00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY89999WR241Medicare PIN
I38750Medicare UPIN