Provider Demographics
NPI:1528535275
Name:STAPLETON, DANIANN
Entity Type:Individual
Prefix:
First Name:DANIANN
Middle Name:
Last Name:STAPLETON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANIANN
Other - Middle Name:
Other - Last Name:POLITI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:48 CALVERT AVE
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-5900
Mailing Address - Country:US
Mailing Address - Phone:631-553-9642
Mailing Address - Fax:
Practice Address - Street 1:48 CALVERT AVE
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-5900
Practice Address - Country:US
Practice Address - Phone:631-553-9642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist