Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 256309 | NY |
NPI | 1003930470 |
---|---|
Provider Name | Dr. Darci Beiras |
First Address | Saranac Lake, NY 12983-2302 |
Second Address | Tupper Lake, NY 12986-2014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 06/01/2011 |