Provider Demographics
NPI:1174931141
Name:HAN, DANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:HAN
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 1:18 HILLIARD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1953
Mailing Address - Country:US
Mailing Address - Phone:773-999-9935
Mailing Address - Fax:201-840-6224
Practice Address - Street 1:18 HILLIARD AVE STE B
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1953
Practice Address - Country:US
Practice Address - Phone:773-999-9935
Practice Address - Fax:201-840-6224
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012654111NR0400X, 111NX0800X, 111NS0005X, 111N00000X
NJ25MZ00179500171100000X
NJ38MC00736000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1174931141Medicaid