Provider Demographics
NPI:1386627149
Name:MARGOLIN, DANIEL L (DPM)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:MARGOLIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:L
Other - Last Name:MARGOLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:550 KINDERKAMACK RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1500
Mailing Address - Country:US
Mailing Address - Phone:201-261-9445
Mailing Address - Fax:201-261-0058
Practice Address - Street 1:680 KINDERKAMACK RD STE 204
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1600
Practice Address - Country:US
Practice Address - Phone:201-261-9445
Practice Address - Fax:201-261-0058
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00173500213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ172726ZFX0Medicare PIN
NJ4972360001Medicare NSC
T44978Medicare UPIN
NJ441642Medicare PIN
NJ441642M35Medicare PIN