1871701532 NPI number — DANIEL O. DADA, M.D., P.C.

Table of content: (NPI 1871701532)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871701532 NPI number — DANIEL O. DADA, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL O. DADA, M.D., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871701532
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2621 W 9TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19013-2115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-494-7666
Provider Business Mailing Address Fax Number:
610-494-9025

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2621 W 9TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19013-2115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-494-7666
Provider Business Practice Location Address Fax Number:
610-494-9025
Provider Enumeration Date:
05/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DADA
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
O.
Authorized Official Title or Position:
PEDIATRICIAN
Authorized Official Telephone Number:
610-494-7666

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD030353-E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1131507 . This is a "KEYSTONE MERCY-GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0031509000 . This is a "KEYSTONE EAST-INDIVIDUAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0784853002 . This is a "KEYSTONE EAST-GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0784853000 . This is a "PERSONAL CHOICE-GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2360241 . This is a "AETNA - GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1060046 . This is a "KEYSTONE MERCY-INDIVIDUAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2360247 . This is a "AETNA-INDIVIDUAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0031509000 . This is a "PERSONAL CHOICE-IND." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0092891305 . This is a "AMERICHOICE OF PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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