Provider Demographics
NPI:1629844543
Name:DUMAS, DARREN MICHAEL
Entity Type:Individual
Prefix:MR
First Name:DARREN
Middle Name:MICHAEL
Last Name:DUMAS
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 1:355 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1827
Mailing Address - Country:US
Mailing Address - Phone:518-481-1673
Mailing Address - Fax:
Practice Address - Street 1:355 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1827
Practice Address - Country:US
Practice Address - Phone:518-481-1673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency