Provider Demographics
NPI:1003018102
Name:COTTER, DANIEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:COTTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3712 SOUTHWESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1720
Mailing Address - Country:US
Mailing Address - Phone:716-432-2253
Mailing Address - Fax:
Practice Address - Street 1:811 MAPLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3260
Practice Address - Country:US
Practice Address - Phone:716-631-8888
Practice Address - Fax:716-648-3185
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA100203207W00000X
NY233935207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY233935OtherNY LICENSE