Provider Demographics
NPI:1083012553
Name:MALKAN, DARSHI
Entity Type:Individual
Prefix:
First Name:DARSHI
Middle Name:
Last Name:MALKAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 LYNGATE CT
Mailing Address - Street 2:STE 203
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1673
Mailing Address - Country:US
Mailing Address - Phone:703-239-2310
Mailing Address - Fax:703-239-2311
Practice Address - Street 1:7659 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-7504
Practice Address - Country:US
Practice Address - Phone:301-434-1850
Practice Address - Fax:301-434-1853
Is Sole Proprietor?:No
Enumeration Date:2014-12-15
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8825 - 0029OtherCAREFIRST