Provider Demographics
NPI:1518375609
Name:GAUCHER, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:GAUCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 HORN RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:CT
Mailing Address - Zip Code:06280-1027
Mailing Address - Country:US
Mailing Address - Phone:860-933-6319
Mailing Address - Fax:
Practice Address - Street 1:6 STORRS RD
Practice Address - Street 2:SUITE 3
Practice Address - City:MANSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06250
Practice Address - Country:US
Practice Address - Phone:860-933-6319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8070225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist