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Organization

INDRA D. DANIELS PHYSICIAN PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. INDRA D. DANIELS PHYSICIAN PLLC (OWNER)
(516) 255-4200
Entity
Organization

Contact information

Practice address
2000 N. VILLAGE AVE SUITE 314, ROCKVILLE CENTRE, NY 11570
(516) 255-4200
(516) 594-2623
Mailing address
1315 BROADWAY UNIT B SUITE 120, HEWLETT, NY 11557
(516) 255-4200
(516) 594-2623

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
187876
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01851367
NY
Enumeration date
04/19/2007
Last updated
10/22/2007
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