Provider Demographics
NPI:1083251912
Name:MICHAELS, DANIEL (ATC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MICHAELS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 PINE NECK AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-5728
Mailing Address - Country:US
Mailing Address - Phone:631-291-8108
Mailing Address - Fax:
Practice Address - Street 1:64 PINE NECK AVE
Practice Address - Street 2:
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-5728
Practice Address - Country:US
Practice Address - Phone:631-291-8108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer