Provider Demographics
NPI:1417102658
Name:DANIEL, CARY (MD)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:
Last Name:DANIEL
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 1:493 N BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-1007
Mailing Address - Country:US
Mailing Address - Phone:516-395-9768
Mailing Address - Fax:
Practice Address - Street 1:2316 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3840
Practice Address - Country:US
Practice Address - Phone:718-209-3333
Practice Address - Fax:718-951-0238
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251085207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine