Provider Demographics
NPI:1467744789
Name:OPAM, DANIELLE REGISTRE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:REGISTRE
Last Name:OPAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26429 60TH RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2541
Mailing Address - Country:US
Mailing Address - Phone:718-224-8314
Mailing Address - Fax:718-276-8666
Practice Address - Street 1:26429 60TH RD
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-2541
Practice Address - Country:US
Practice Address - Phone:718-224-8314
Practice Address - Fax:718-276-8666
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181627208100000X, 2081N0008X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine