Provider Demographics
NPI:1184157919
Name:ANDREAS, DARIAN (MD)
Entity type:Individual
Prefix:DR
First Name:DARIAN
Middle Name:
Last Name:ANDREAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 QUEENS BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-1660
Mailing Address - Country:US
Mailing Address - Phone:929-483-2030
Mailing Address - Fax:917-832-6768
Practice Address - Street 1:4701 QUEENS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-1660
Practice Address - Country:US
Practice Address - Phone:929-483-2030
Practice Address - Fax:917-832-6768
Is Sole Proprietor?:No
Enumeration Date:2017-04-08
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY31712901208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program