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Individual

DANIEL T PHELAN

Active
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Individual

DANIEL T PHELAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
219592-3
NY
207XX0801X
Orthopaedic Trauma Physician
219592-3
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000416120001
BS NENY
NY
05
02563266
NY
01
10086280
CDPHP
NY
01
371186
MVP
NY
01
580F71
EMPIRE BC
NY
01
7667619
AETNA
NY
Enumeration date
10/11/2006
Last updated
08/07/2026
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