Dr. Daniel E Distasi
Periodontist
700 Broadway Ste 64
Westwood
, New Jersey 07675-1674
Dr. Daniel E Distasi
Periodontist
700 Broadway Ste 64
Westwood
, New Jersey 07675-1674
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Daniel E Distasi
- 200 W 57th St Ste 410
- New York, NY
- Zip : 10019-3211
- Phone :
Second Address
- Dr. Daniel E Distasi
- 700 Broadway Ste 64
- Westwood, NJ
- Zip : 07675-1674
- Fax : (201) 666-2055
- Phone : (201) 666-1300
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 22DI01442602 | NJ |
National Provider Identifier
| NPI | 1104910942 |
|---|---|
| Provider Name | Dr. Daniel E Distasi |
| First Address | New York, NY 10019-3211 |
| Second Address | Westwood, NJ 07675-1674 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/10/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.