Provider Demographics
NPI:1558626192
Name:DANSKY, JARED
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:DANSKY
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 1:522 W 112TH ST APT 54
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1689
Mailing Address - Country:US
Mailing Address - Phone:551-404-5633
Mailing Address - Fax:
Practice Address - Street 1:522 W 112TH ST APT 54
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1689
Practice Address - Country:US
Practice Address - Phone:551-404-5633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist