Provider Demographics
NPI:1518019702
Name:MINER, DANIEL WAYNE (MD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:WAYNE
Last Name:MINER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:68 S SERVICE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2354
Mailing Address - Country:US
Mailing Address - Phone:516-945-3000
Mailing Address - Fax:516-945-3131
Practice Address - Street 1:636 WANTAGH AVE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-5325
Practice Address - Country:US
Practice Address - Phone:516-520-7750
Practice Address - Fax:516-520-1052
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2009-11-12
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Provider Licenses
StateLicense IDTaxonomies
NY134549208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01834468Medicaid