Individual
PETER DANIOLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26 CENTRAL ST, SOMERVILLE, MA 02143-2827
(617) 665-3220
Mailing address
26 CENTRAL ST, SOMERVILLE, MA 02143-2827
(617) 665-3220
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
MD32319
DC
2084P0804X
Child & Adolescent Psychiatry Physician
39184
IA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
77404
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77404
MA LICENSE
MA
Enumeration date
10/14/2006
Last updated
03/17/2022
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