1609071299 NPI number — ROXANNE NICOLE DANIELSON M.D. M.P.H. M.S.

Table of content: ROXANNE NICOLE DANIELSON M.D. M.P.H. M.S. (NPI 1609071299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609071299 NPI number — ROXANNE NICOLE DANIELSON M.D. M.P.H. M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANIELSON
Provider First Name:
ROXANNE
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D. M.P.H. M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LANDESMAN
Provider Other First Name:
ROXANNE
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D. M.P.H. M.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609071299
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12038 CHASE CROSSING CIR
Provider Second Line Business Mailing Address:
APT 403
Provider Business Mailing Address City Name:
ROCKVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20852-4764
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-320-8756
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NATIONAL NAVAL MEDICAL CTR
Provider Second Line Business Practice Location Address:
8901 WISCONSIN AVE
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20889-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-319-8278
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X , with the licence number: 010244208 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)