Provider Demographics
NPI:1043304686
Name:KAWASH, DANIEL M (PA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:KAWASH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 KUSER RD STE 3
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-3386
Mailing Address - Country:US
Mailing Address - Phone:609-896-0444
Mailing Address - Fax:609-896-1126
Practice Address - Street 1:2501 KUSER RD STE 3
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08691
Practice Address - Country:US
Practice Address - Phone:609-896-0444
Practice Address - Fax:609-896-1126
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00137600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P76886Medicare UPIN
PA089428PGOMedicare ID - Type Unspecified
NJ088852L7UMedicare ID - Type Unspecified