Provider Demographics
NPI:1013010867
Name:DANADIAN, KAPRIEL (MD)
Entity Type:Individual
Prefix:
First Name:KAPRIEL
Middle Name:
Last Name:DANADIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2440
Mailing Address - Country:US
Mailing Address - Phone:315-363-2350
Mailing Address - Fax:315-361-1827
Practice Address - Street 1:421 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2440
Practice Address - Country:US
Practice Address - Phone:315-363-2350
Practice Address - Fax:315-361-1827
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0009721208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02023563Medicaid