Blackstock, Daryle Marc

Blackstock, Daryle Marc is an sole proprietor health care provider with primary practice located at 622 W 168Th St Ph 14, Rm 104, New York NY 10032-3720. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Blackstock, Daryle Marc can be contacted via phone (212) 305-7771.

Contact Information

Primary practice address
622 W 168Th St Ph 14, Rm 104 New York NY 10032-3720
Phone: (212) 305-7771
Fax: (212) 342-5307
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 006279-1 New York

Profile Details

NPI number 1295820298
LBN Legal business name Blackstock, Daryle Marc
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2006
Last updated Jul 15th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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