Provider Demographics
NPI:1083748396
Name:VAN-ZANDT, DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:VAN-ZANDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 VIRGINIA RD.
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603
Mailing Address - Country:US
Mailing Address - Phone:914-428-8400
Mailing Address - Fax:914-428-4060
Practice Address - Street 1:78 VIRGINIA RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603
Practice Address - Country:US
Practice Address - Phone:914-428-8400
Practice Address - Fax:914-428-4060
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008727-2111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U74067Medicare UPIN