Provider Demographics
NPI:1518187574
Name:FUINA-DARRAH, GLORIA (RPA)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:FUINA-DARRAH
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BRYANT'S COUNTRY SQUARE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12083
Mailing Address - Country:US
Mailing Address - Phone:518-966-8786
Mailing Address - Fax:
Practice Address - Street 1:20 BRYANT'S COUNTRY SQUARE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12083
Practice Address - Country:US
Practice Address - Phone:518-966-8786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000712363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant