Provider Demographics
NPI:1720363559
Name:DAREN, ANDREW M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:M
Last Name:DAREN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CENTRAL PARK S APT 2B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1435
Mailing Address - Country:US
Mailing Address - Phone:860-608-6391
Mailing Address - Fax:
Practice Address - Street 1:240 CENTRAL PARK S
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1457
Practice Address - Country:US
Practice Address - Phone:800-608-6391
Practice Address - Fax:860-608-6391
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020211103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical