Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0122X | Plastic and Reconstructive Surgery | 2047291 | NY |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 25MA07326800 | NJ |
NPI | 1164520136 |
---|---|
Provider Name | Dr. David Daniels |
First Address | Summit, NJ 07901 |
Second Address | Summit, NJ 07901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2007 |