Provider Demographics
NPI:1346335023
Name:HYMAN, DANIEL J (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:HYMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08030-1706
Mailing Address - Country:US
Mailing Address - Phone:856-456-0518
Mailing Address - Fax:856-456-4359
Practice Address - Street 1:14 S BROADWAY
Practice Address - Street 2:
Practice Address - City:GLOUCESTER CITY
Practice Address - State:NJ
Practice Address - Zip Code:08030-1706
Practice Address - Country:US
Practice Address - Phone:856-456-0518
Practice Address - Fax:856-456-4359
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB58028207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0725322000OtherAMERIHEALTH, KEYSTONE, IBC
3530533OtherAETNA
NJ6310206Medicaid
1012888OtherHORIZON NJ HEALTH
3530533OtherAETNA
G01889Medicare UPIN