Provider Demographics
NPI:1477160612
Name:POKOEVAYA, DARYA (MSN, PMHNP)
Entity Type:Individual
Prefix:
First Name:DARYA
Middle Name:
Last Name:POKOEVAYA
Suffix:
Gender:F
Credentials:MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3137
Mailing Address - Country:US
Mailing Address - Phone:781-819-4436
Mailing Address - Fax:307-459-6607
Practice Address - Street 1:20 W EMERSON ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3137
Practice Address - Country:US
Practice Address - Phone:781-819-4436
Practice Address - Fax:307-459-6607
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2284748363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health