Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | OS011877 | PA |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 25MB08313400 | NJ |
NPI | 1801864392 |
---|---|
Provider Name | Joseph Daniel |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Egg Harbor Township, NJ 08234-5549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 10/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017238590004 | (05) | PA |
8847002 | (05) | NJ |
G68800 | (02) |