Provider Demographics
NPI:1629051131
Name:MOLCSAN, DANIEL RICHARD JR (DPM)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RICHARD
Last Name:MOLCSAN
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:RICHARD
Other - Last Name:MOLCSAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:4800 FRIENDSHIP AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1722
Mailing Address - Country:US
Mailing Address - Phone:412-688-7580
Mailing Address - Fax:412-681-9676
Practice Address - Street 1:4800 FRIENDSHIP AVE FL 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-688-7580
Practice Address - Fax:412-681-9676
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003521L213EP1101X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001261244Medicaid
PAU24092Medicare UPIN
PA5757580004Medicare NSC
PA001261244Medicaid
PA182988Medicare PIN
PA1918663Medicare PIN
PA5757580001Medicare NSC
PA5757580004Medicare NSC
PA182988Medicare PIN
PA5757580004Medicare NSC