1992796114 NPI number — DANIEL MAGALNICK D.M.D.

Table of content: DANIEL MAGALNICK D.M.D. (NPI 1992796114)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992796114 NPI number — DANIEL MAGALNICK D.M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAGALNICK
Provider First Name:
DANIEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.M.D.
Provider Gender Code:
M

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:
1992796114
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 ESSEX CENTER DR
Provider Second Line Business Mailing Address:
SUITE 112
Provider Business Mailing Address City Name:
PEABODY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01960-2910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-531-1450
Provider Business Mailing Address Fax Number:
978-531-9984

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 ESSEX CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 112
Provider Business Practice Location Address City Name:
PEABODY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01960-2910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-531-1450
Provider Business Practice Location Address Fax Number:
978-531-9984
Provider Enumeration Date:
11/04/2005

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: 1223S0112X , with the licence number:  13222 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 41946 . This is a "HP-MELROSE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 709518 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA58597 . This is a "HP-NBPT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: V06392 . This is a "BCBS NBPT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: X04063 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 16303 . This is a "PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: V05676 . This is a "BCBS MELROSE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0261475 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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