Provider Demographics
NPI:1578335055
Name:ANNANG, DANIEL ADJEI
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ADJEI
Last Name:ANNANG
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 1:1491 MACOMBS RD APT 3J
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-2128
Mailing Address - Country:US
Mailing Address - Phone:347-791-3394
Mailing Address - Fax:
Practice Address - Street 1:1491 MACOMBS RD APT 3J
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-2128
Practice Address - Country:US
Practice Address - Phone:347-791-3394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5874OtherHEALTH PARTNERS
NY236Medicaid
568946544OtherBCBS