Provider Demographics
NPI:1629471610
Name:DUFFY, DANIEL J (SURIGICAL ASSIST(SA))
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:DUFFY
Suffix:
Gender:M
Credentials:SURIGICAL ASSIST(SA)
Other - Prefix:MR
Other - First Name:DANIEL
Other - Middle Name:J
Other - Last Name:DUFFY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SA
Mailing Address - Street 1:4872 N SILVERLACE DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-8653
Mailing Address - Country:US
Mailing Address - Phone:720-290-1373
Mailing Address - Fax:
Practice Address - Street 1:4872 N SILVERLACE DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8653
Practice Address - Country:US
Practice Address - Phone:720-290-1373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14-503246ZC0007X
CO246ZC0007X282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant