Provider Demographics
NPI:1184662488
Name:BECKER, DANIEL L (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:BECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3 WESTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:NH
Mailing Address - Zip Code:03033-4421
Mailing Address - Country:US
Mailing Address - Phone:603-400-0160
Mailing Address - Fax:
Practice Address - Street 1:545 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-3117
Practice Address - Country:US
Practice Address - Phone:508-697-3677
Practice Address - Fax:508-697-9396
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210720207Q00000X
NH9510207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3086747Medicaid
MA110077744AMedicaid
MA0002282Medicare PIN