Provider Demographics
NPI:1528529963
Name:DARU, NAMRATA SANJEEV (DPM)
Entity type:Individual
Prefix:DR
First Name:NAMRATA
Middle Name:SANJEEV
Last Name:DARU
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:NAMRATA
Other - Middle Name:S
Other - Last Name:DARU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:2790 GODWIN BLVD STE 355
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8173
Mailing Address - Country:US
Mailing Address - Phone:757-983-8520
Mailing Address - Fax:
Practice Address - Street 1:2790 GODWIN BLVD STE 355
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8173
Practice Address - Country:US
Practice Address - Phone:757-983-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0103301357213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program