Provider Demographics
NPI:1265034730
Name:FADDEN, DANIEL P (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:FADDEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 E BOOT RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5934
Mailing Address - Country:US
Mailing Address - Phone:610-241-1061
Mailing Address - Fax:
Practice Address - Street 1:1375 E BOOT RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5934
Practice Address - Country:US
Practice Address - Phone:610-241-1061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067362183500000X
PARP452532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist