Provider Demographics
NPI:1679663637
Name:DARMOCHWAL, VANESSA MARY (DPM)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARY
Last Name:DARMOCHWAL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CAREMOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:2507 SOUTH RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-5458
Practice Address - Country:US
Practice Address - Phone:845-231-5600
Practice Address - Fax:845-231-5489
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN005278-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01879643Medicaid
NY01879643Medicaid
NYA400085672Medicare PIN
NYP1034534OtherOXFORD
NY204295438 0006OtherCIGNA
NY9108OtherGHI
NY01879643Medicaid
NYPCWB51OtherAARP
NY2C6599OtherHEALTHNET
NY204295438OtherSEIBA
NY989630OtherMVP
NYPCWB51OtherFIRST UNITED AMERICAN LIF
NY204295438OtherLOOMIS COMPANY
NYP10831OtherBLUE CROSS BLUE SHIELD
NY10035850OtherCDPHP
NYP68362Medicare ID - Type Unspecified
NY204295438OtherWELLCARE
NYNY9999OtherMUTUAL OF OMAHA
NYU62526Medicare UPIN