Provider Demographics
NPI:1164482428
Name:SANCHEZ, DANIEL RENE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RENE
Last Name:SANCHEZ
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 1:5912 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-2112
Mailing Address - Country:US
Mailing Address - Phone:201-861-0077
Mailing Address - Fax:201-861-9595
Practice Address - Street 1:5912 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-2112
Practice Address - Country:US
Practice Address - Phone:201-861-0077
Practice Address - Fax:201-861-9595
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 715722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8428409Medicaid
NJ045488Medicare ID - Type Unspecified
NJ8428409Medicaid