Provider Demographics
NPI:1437136579
Name:BEYDA, DANIEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:E
Last Name:BEYDA
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 1:1311 CLUB DRIVE
Mailing Address - Street 2:
Mailing Address - City:HEWLETT HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11557
Mailing Address - Country:US
Mailing Address - Phone:516-569-9731
Mailing Address - Fax:
Practice Address - Street 1:4334 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-2412
Practice Address - Country:US
Practice Address - Phone:212-927-1717
Practice Address - Fax:516-908-7654
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2195432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02425381Medicaid
NY07075MMedicare PIN
NYH82044Medicare UPIN
NY06544LMedicare PIN
NY636T913091Medicare PIN
NY636T998391Medicare PIN
NY02425381Medicaid
NY05517PMedicare PIN