Provider Demographics
NPI:1497925416
Name:DANIEL G CANARIO M D P C
Entity Type:Organization
Organization Name:DANIEL G CANARIO M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:GOMES
Authorized Official - Last Name:CANARIO
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:516-731-5532
Mailing Address - Street 1:121 RITA DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1326
Mailing Address - Country:US
Mailing Address - Phone:516-731-5532
Mailing Address - Fax:
Practice Address - Street 1:121 RITA DR
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1326
Practice Address - Country:US
Practice Address - Phone:516-690-3639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228892207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI25702Medicare UPIN
NY06939Medicare PIN