Provider Demographics
NPI:1922399757
Name:DARAKCHIEVA, EUJENIA MOMCHILOVA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:EUJENIA
Middle Name:MOMCHILOVA
Last Name:DARAKCHIEVA
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1175 MONTAUK HWY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4939
Mailing Address - Country:US
Mailing Address - Phone:631-669-1171
Mailing Address - Fax:631-669-1912
Practice Address - Street 1:1175 MONTAUK HWY
Practice Address - Street 2:SUITE 3
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4939
Practice Address - Country:US
Practice Address - Phone:631-669-1171
Practice Address - Fax:631-669-1912
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
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Provider Licenses
StateLicense IDTaxonomies
NY010842363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical