Provider Demographics
NPI:1750376380
Name:ESAKOF, DARRYL D (MD)
Entity type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:D
Last Name:ESAKOF
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:DEPARTMENT OF CARDIOVASCULAR MEDICINE, LAHEY CLINIC
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8461
Mailing Address - Fax:781-744-5261
Practice Address - Street 1:41 MALL ROAD
Practice Address - Street 2:DEPARTMENT OF CARDIOVASCULAR MEDICINE, LAHEY CLINIC
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805
Practice Address - Country:US
Practice Address - Phone:781-744-8461
Practice Address - Fax:781-744-5261
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA728952083C0008X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110050470AMedicaid
MA110050470AMedicaid
E91420Medicare UPIN