Individual
DANIEL JERAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
521 ROUTE 111, SUITE 309, HAUPPAUGE, NY 11788-4370
(631) 979-7654
(631) 979-4002
Mailing address
521 ROUTE 111, SUITE 309, HAUPPAUGE, NY 11788-4370
(631) 979-7654
(631) 979-4002
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N004563-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021194
GHI
NY
01
—
003728
PHS
NM
01
—
00456301
SUFFOLK HEALTH PLAN
NY
05
—
01635689
—
NY
01
—
0941080001
MEDICARE DME
NY
01
—
10158
VYTRA
NY
01
—
108845
108845
NY
01
—
113102546001
TRICARE
NY
01
—
4343388
AETNA
NY
01
—
470624
USHC
NY
01
—
7720375006
CIGNA
NY
01
—
ANTHEM
030004563NY01
NY
01
—
CS641
OXFORD
NY
01
—
P50852
BCBS
NY
Enumeration date
06/07/2006
Last updated
05/05/2008
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