Provider Demographics
NPI:1114960523
Name:O'CONNOR, DANIEL RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RICHARD
Last Name:O'CONNOR
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 1:9438 58TH AVE
Mailing Address - Street 2:UNIT G-3
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5149
Mailing Address - Country:US
Mailing Address - Phone:718-393-3900
Mailing Address - Fax:718-393-3999
Practice Address - Street 1:9438 58TH AVE
Practice Address - Street 2:UNIT G-3
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5149
Practice Address - Country:US
Practice Address - Phone:718-393-3900
Practice Address - Fax:718-393-3999
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164167207XP3100X, 207XS0106X, 207XS0114X, 207XX0004X, 207XX0005X, 207XX0801X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01707148Medicaid
NY61H462Medicare ID - Type Unspecified
NY01707148Medicaid
NYF55489Medicare UPIN