Provider Demographics
NPI:1508822750
Name:LINCOLN, DANIEL D (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:D
Last Name:LINCOLN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-0617
Mailing Address - Country:US
Mailing Address - Phone:203-381-9703
Mailing Address - Fax:203-381-9802
Practice Address - Street 1:3355 MAIN ST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4845
Practice Address - Country:US
Practice Address - Phone:203-381-9703
Practice Address - Fax:203-381-9802
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050001204CT01OtherANTHEM BLUE CROSS
CTCT01204OtherLANDMARK
CT992075OtherACS HEALTHNET OF NORTHEAS
CTP3250597OtherOXFORD