Provider Demographics
NPI:1235128505
Name:VANARSDALE, DANIEL M (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:VANARSDALE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:330 MEETING HOUSE LANE
Mailing Address - Street 2:SOUTHAMPTON HOSPITAL ANNEX
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968
Mailing Address - Country:US
Mailing Address - Phone:631-726-0409
Mailing Address - Fax:631-726-0406
Practice Address - Street 1:80 OLD RIVERHEAD RD
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-1401
Practice Address - Country:US
Practice Address - Phone:631-288-7746
Practice Address - Fax:631-288-7111
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2011-04-28
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Provider Licenses
StateLicense IDTaxonomies
NY2259381207Q00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0974857001OtherCIGNA
NY2259381OtherHIP
NY24884806OtherNYSHIP
NY7524931OtherAETNA
NYP3506220OtherOXFORD
1056138OtherGHI
NY1235128505OtherNPI NUMBER
NY5466D1OtherEMPIRE BLUE CROSS BLUE SHIELD
00002488486OtherUNITED HEALTHCARE
NY1056138OtherEMBLEM HEALTH