Provider Demographics
NPI:1487009890
Name:MEYER, DANIELLE (MS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:MAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:527 BEAR RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2504
Mailing Address - Country:US
Mailing Address - Phone:917-697-5942
Mailing Address - Fax:
Practice Address - Street 1:527 BEAR RIDGE RD
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2504
Practice Address - Country:US
Practice Address - Phone:917-697-5942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY876506174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist