Provider Demographics
NPI:1073620829
Name:TAHANY, DANIEL (PT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:TAHANY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1271
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-1271
Mailing Address - Country:US
Mailing Address - Phone:212-537-0110
Mailing Address - Fax:212-537-6240
Practice Address - Street 1:118 BAXTER ST STE 303
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3675
Practice Address - Country:US
Practice Address - Phone:212-537-0110
Practice Address - Fax:212-537-6240
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ45171Medicare ID - Type Unspecified
NYQ46171Medicare PIN