Individual
DR. DANIEL FANOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 HOSPITAL PLZ, OLD BRIDGE, NJ 08857-3012
(732) 360-1000
Mailing address
46 BARTLETT AVE, STATEN ISLAND, NY 10312-2462
(646) 251-6732
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MB11532600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2018
Last updated
07/12/2022
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