Provider Demographics
NPI:1952515264
Name:GODKAR, DARSHAN P (MD)
Entity type:Individual
Prefix:MR
First Name:DARSHAN
Middle Name:P
Last Name:GODKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:65 RIDGEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927-1313
Mailing Address - Country:US
Mailing Address - Phone:973-401-1100
Mailing Address - Fax:973-401-1201
Practice Address - Street 1:65 RIDGEDALE AVE
Practice Address - Street 2:
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-1313
Practice Address - Country:US
Practice Address - Phone:973-401-1100
Practice Address - Fax:973-401-1201
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA08608400207RC0000X
NJ25MA08608400207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ157340P8CMedicare PIN