Individual provider Active NPI

Daria Klachko, MD

  • Obstetrics & Gynecology Physician
  • West Orange, NJ
National Provider Identifier
1255449724
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MA065734 Issued in NJ
Practice address
769 Northfield Ave
Suite 236
West Orange, NJ 07052-1198
Phone
(973) 325-5670
NPI assigned
Aug 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MA065734 NJ Primary

Addresses

Primary practice location

769 Northfield Ave
Suite 236
West Orange, NJ 07052-1198

Mailing address

11 Heritage Rd
Florham Park, NJ 07932-2217
Phone (973) 325-5670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA065734NJMDObstetrics & Gynecology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1255449724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HERITAGE RD",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079322217",
            "telephone_number": "973-325-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 NORTHFIELD AVE",
            "address_2": "SUITE 236",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521198",
            "telephone_number": "973-325-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLACHKO",
        "first_name": "DARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-26",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "MA065734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.