1164121695 NPI number — DANIELLE S MCLAUGHLIN

Table of content: DANIELLE S MCLAUGHLIN (NPI 1164121695)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164121695 NPI number — DANIELLE S MCLAUGHLIN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCLAUGHLIN
Provider First Name:
DANIELLE
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1164121695
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8101 COMMANDANT WAY APT 27
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANLIUS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13104-2054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-564-8240
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18709 LINDEN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT ALBANS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11412-4025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-500-5549
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2023

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: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: K1006700902 . This is a "EMBLEM HEALTH" identifier . This identifiers is of the category "OTHER".




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