Provider Demographics
NPI:1356602759
Name:HALL, DARRYL BRIAN (RN)
Entity type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:BRIAN
Last Name:HALL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 WILLOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-3054
Mailing Address - Country:US
Mailing Address - Phone:716-418-0400
Mailing Address - Fax:
Practice Address - Street 1:308 WILLOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-3054
Practice Address - Country:US
Practice Address - Phone:716-418-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY656274-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse