Provider Demographics
NPI:1588221758
Name:DANNIEL, NEDA (MD)
Entity Type:Individual
Prefix:DR
First Name:NEDA
Middle Name:
Last Name:DANNIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:NEDA
Other - Middle Name:
Other - Last Name:TUTTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:908 ELAINES CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-8617
Mailing Address - Country:US
Mailing Address - Phone:570-877-9007
Mailing Address - Fax:
Practice Address - Street 1:150 BROOKLYN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-2274
Practice Address - Country:US
Practice Address - Phone:570-877-9007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD479376207Q00000X
PAMT217690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine