Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 2259381 | NY |
N | 207Q00000X | Family Doctor | 2259381 | NY |
NPI | 1235128505 |
---|---|
Provider Name | Dr. Daniel M Vanarsdale |
First Address | Southampton, NY 11968 |
Second Address | Westhampton Beach, NY 11978-1401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 28/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00002488486 | UNITED HEALTHCARE (01) | |
0974857001 | CIGNA (01) | NY |
1056138 | EMBLEM HEALTH (01) | NY |
1056138 | GHI (01) | |
1235128505 | NPI NUMBER (01) | NY |
2259381 | HIP (01) | NY |
24884806 | NYSHIP (01) | NY |
5466D1 | EMPIRE BLUE CROSS BLUE SHIELD (01) | NY |
7524931 | AETNA (01) | NY |
P3506220 | OXFORD (01) | NY |