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1295820298
DARYLE MARC BLACKSTOCK
NEW YORK, NY
NPI
1295820298
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 006279-1)
Enumeration Date
2006-10-04
Last Update Date
2015-07-15
Business Address
Mr. DARYLE MARC BLACKSTOCK Physician Assistant
622 W 168TH ST PH 14, RM 104
NEW YORK, NY 10032-3720
Phone number: 212-305-7771
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Mailing Address
Mr. DARYLE MARC BLACKSTOCK Physician Assistant
622 W 168TH ST PH 14, RM 104
NEW YORK, NY 10032-3720
Phone number: 212-305-7771
Copy
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