Provider Demographics
NPI:1508889114
Name:IZON, DANIEL O (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:O
Last Name:IZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11649
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-4649
Mailing Address - Country:US
Mailing Address - Phone:212-246-4237
Mailing Address - Fax:212-813-3456
Practice Address - Street 1:1384 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-6108
Practice Address - Country:US
Practice Address - Phone:212-246-4237
Practice Address - Fax:212-813-3456
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY166608-12085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology