Nam, Daniel
Nam, Daniel is an individual health care provider with primary practice located at 160 E Main St , Port Jervis NY 12771-2114. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Nam, Daniel can be contacted via phone (845) 858-7000.Contact Information
Primary practice address
160 E Main St
Port Jervis NY 12771-2114
Phone: (845) 858-7000
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 25MA07999200 | New Jersey |
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD432587 | Pennsylvania |
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 306510 | New York |
Profile Details
NPI number | 1003850413 |
---|---|
LBN Legal business name | Nam, Daniel |
Credentials | MD, PHD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 15th, 2006 |
Last updated | Jul 7th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1003850413 | NPPES |
Pennsylvania | MEDICAID | 1020277300003 | |
Pennsylvania | MEDICAID | 1020277300001 | |
Pennsylvania | MEDICAID | 1020277300002 | |
Pennsylvania | Other | 3432839000 | |
Pennsylvania | Other | 2089031 |
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