Provider Demographics
NPI:1497188981
Name:DANIEL I. SHRAGER M.D., LLC
Entity Type:Organization
Organization Name:DANIEL I. SHRAGER M.D., LLC
Other - Org Name:DANIEL I. SHRAGER, M.D., LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:SHRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-510-6300
Mailing Address - Street 1:19 CONISTON CT
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-7552
Mailing Address - Country:US
Mailing Address - Phone:617-510-6300
Mailing Address - Fax:215-862-4567
Practice Address - Street 1:19 CONISTON CT
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7552
Practice Address - Country:US
Practice Address - Phone:617-510-6300
Practice Address - Fax:215-862-4567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07404700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty