Provider Demographics
NPI:1932515277
Name:KOKALARI, DARIEN
Entity Type:Individual
Prefix:
First Name:DARIEN
Middle Name:
Last Name:KOKALARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2323
Mailing Address - Country:US
Mailing Address - Phone:215-855-8122
Mailing Address - Fax:
Practice Address - Street 1:491 ALLENDALE RD STE 300
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1432
Practice Address - Country:US
Practice Address - Phone:610-337-3322
Practice Address - Fax:610-337-2582
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006555213ES0103X
NJ25MD00343600213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASC006555OtherLICENSE NUMBER