Provider Demographics
NPI:1164487385
Name:DANAKAS, GEORGE T (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:T
Last Name:DANAKAS
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 1:268 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-1637
Mailing Address - Country:US
Mailing Address - Phone:716-652-8606
Mailing Address - Fax:716-652-4448
Practice Address - Street 1:268 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-1637
Practice Address - Country:US
Practice Address - Phone:716-652-8606
Practice Address - Fax:716-652-4448
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157135207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01050953Medicaid
NY01050953Medicaid
NYDD6327Medicare PIN
NYE15450Medicare UPIN