Basic Information
Provider Information
NPI: 1205995552
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PIECHOTA
FirstName: DARREN
MiddleName: F
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 W WASHINGTON SQ
Address2: #1902
City: PHILADELPHIA
State: PA
PostalCode: 191063513
CountryCode: US
TelephoneNumber: 5704302443
FaxNumber:  
Practice Location
Address1: 1 MEDICAL CENTER BLVD
Address2:  
City: CHESTER
State: PA
PostalCode: 190133902
CountryCode: US
TelephoneNumber: 6108745257
FaxNumber: 6108747421
Other Information
ProviderEnumerationDate: 12/06/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0804XMD051013LPAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

No ID Information.


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