Provider Demographics
NPI:1801519285
Name:KVYATKOVSKY, DARIEN
Entity type:Individual
Prefix:
First Name:DARIEN
Middle Name:
Last Name:KVYATKOVSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 GEORGES RD STE 103B
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3377
Mailing Address - Country:US
Mailing Address - Phone:929-215-9860
Mailing Address - Fax:
Practice Address - Street 1:622 GEORGES RD STE 103B
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-3377
Practice Address - Country:US
Practice Address - Phone:929-215-9860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)