Provider Demographics
NPI:1730153404
Name:BJORK, DARLA ANN (MD)
Entity type:Individual
Prefix:
First Name:DARLA
Middle Name:ANN
Last Name:BJORK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3408
Mailing Address - Country:US
Mailing Address - Phone:212-219-3680
Mailing Address - Fax:212-925-4777
Practice Address - Street 1:91 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3408
Practice Address - Country:US
Practice Address - Phone:212-219-3680
Practice Address - Fax:212-925-4777
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09902512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B19458Medicare UPIN
NY81D941Medicare ID - Type Unspecified