Provider Demographics
NPI:1578324877
Name:LOFTIN, DARRI-ANE P (INDIVIDUAL (SPED))
Entity Type:Individual
Prefix:
First Name:DARRI-ANE
Middle Name:P
Last Name:LOFTIN
Suffix:
Gender:F
Credentials:INDIVIDUAL (SPED)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11503 180TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-1418
Mailing Address - Country:US
Mailing Address - Phone:347-965-8364
Mailing Address - Fax:
Practice Address - Street 1:2447 ESTCHESTER ROAD
Practice Address - Street 2:2ND. FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469
Practice Address - Country:US
Practice Address - Phone:718-882-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1756183231252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency