Provider Demographics
NPI:1245594225
Name:DANILOV, TAMIR (DPM)
Entity Type:Individual
Prefix:DR
First Name:TAMIR
Middle Name:
Last Name:DANILOV
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 LITTLE WEST ST
Mailing Address - Street 2:APT #24C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-7410
Mailing Address - Country:US
Mailing Address - Phone:212-598-4300
Mailing Address - Fax:
Practice Address - Street 1:150 DELANCEY ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-3308
Practice Address - Country:US
Practice Address - Phone:212-598-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY006701213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program