Provider Demographics
NPI:1326010034
Name:BOKOR, DAVID (MSN, NP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:BOKOR
Suffix:
Gender:M
Credentials:MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 WEST STATE STREET
Mailing Address - Street 2:CATHOLIC CHARITIES
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618
Mailing Address - Country:US
Mailing Address - Phone:609-394-5181
Mailing Address - Fax:
Practice Address - Street 1:383 W STATE ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-5705
Practice Address - Country:US
Practice Address - Phone:609-394-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN10407700363LA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8337004Medicaid
025635Medicare ID - Type Unspecified
NJ8337004Medicaid