Provider Demographics
NPI:1366797599
Name:GARNES, DARIS AUDREY (TEACHER)
Entity type:Individual
Prefix:MISS
First Name:DARIS
Middle Name:AUDREY
Last Name:GARNES
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6018 BEACH FRONT RD
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1280
Mailing Address - Country:US
Mailing Address - Phone:347-581-8753
Mailing Address - Fax:
Practice Address - Street 1:6018 BEACH FRONT RD
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1280
Practice Address - Country:US
Practice Address - Phone:347-581-8753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist