Provider Demographics
NPI:1407952104
Name:ADLER, DANIEL J (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E 61ST ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-8722
Mailing Address - Country:US
Mailing Address - Phone:212-826-3903
Mailing Address - Fax:212-339-9984
Practice Address - Street 1:425 E 61ST ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8722
Practice Address - Country:US
Practice Address - Phone:212-826-3903
Practice Address - Fax:212-339-9984
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY158342207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01506770Medicaid
NYA61324Medicare UPIN
NY01506770Medicaid