1831137819 NPI number — DR. DANIEL M THAILER MD

Table of content: DR. DANIEL M THAILER MD (NPI 1831137819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831137819 NPI number — DR. DANIEL M THAILER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THAILER
Provider First Name:
DANIEL
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1831137819
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 SHIRLEY TERRACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINNELON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-493-2605
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2825 RANDOLPH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28211-1018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-492-8402
Provider Business Practice Location Address Fax Number:
828-327-4245
Provider Enumeration Date:
06/03/2006

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: 207L00000X , with the licence number:  2010-00405 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com