Individual
DANIIL NIYAZOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 DELAWARE AVE STE 100, DELMAR, NY 12054-1402
(518) 439-8077
(518) 439-8070
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
288680
NY
390200000X
Student in an Organized Health Care Education/Training Program
63498
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04823314
—
NY
Enumeration date
04/09/2014
Last updated
07/21/2022
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