1922423094 NPI number — MR. JAMES HAWKINS DANIELS III L.M.T.

Table of content: MR. JAMES HAWKINS DANIELS III L.M.T. (NPI 1922423094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922423094 NPI number — MR. JAMES HAWKINS DANIELS III L.M.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANIELS
Provider First Name:
JAMES
Provider Middle Name:
HAWKINS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
III
Provider Credential Text:
L.M.T.
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:
1922423094
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1019 STATE ROUTE 17M
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10950-1643
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-781-5890
Provider Business Mailing Address Fax Number:
516-599-2185

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1019 STATE ROUTE 17M
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10950-1643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-781-5890
Provider Business Practice Location Address Fax Number:
516-599-2185
Provider Enumeration Date:
02/26/2014

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: 225700000X , with the licence number:  025942-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 025942-1 . This is a "STATE LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com