Provider Demographics
NPI:1225025547
Name:ROSHAN, DANIEL F (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:F
Last Name:ROSHAN
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:PO BOX 645977
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-5977
Mailing Address - Country:US
Mailing Address - Phone:212-725-0123
Mailing Address - Fax:718-253-2333
Practice Address - Street 1:213 MADISON AVE STE 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3814
Practice Address - Country:US
Practice Address - Phone:212-249-3949
Practice Address - Fax:212-249-3916
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197504207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01860044Medicaid
NYG73345Medicare UPIN
NY01860044Medicaid