Individual
HALEY DANIELLE KAMENIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
269 PORTLAND WAY S, GALION, OH 44833-2312
(419) 468-4841
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4304
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.002890
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0090732
—
OH
01
—
H403852
MEDICARE
OH
Enumeration date
06/15/2009
Last updated
11/18/2020
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