Provider Demographics
NPI:1104320035
Name:TEREKHOVA, DARYA (MD)
Entity type:Individual
Prefix:
First Name:DARYA
Middle Name:
Last Name:TEREKHOVA
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 1:160 COMMONWEALTH AVE STE U3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2749
Mailing Address - Country:US
Mailing Address - Phone:914-320-3150
Mailing Address - Fax:
Practice Address - Street 1:160 COMMONWEALTH AVE STE U3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2749
Practice Address - Country:US
Practice Address - Phone:914-320-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2925822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry