Provider Demographics
NPI:1689668683
Name:DANISKAS, EFTHYMIOS I (MD)
Entity Type:Individual
Prefix:DR
First Name:EFTHYMIOS
Middle Name:I
Last Name:DANISKAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 419430
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-9430
Mailing Address - Country:US
Mailing Address - Phone:201-967-8221
Mailing Address - Fax:201-483-2242
Practice Address - Street 1:311 BAY AVE
Practice Address - Street 2:MMG PULMONOLOGY
Practice Address - City:GLEN RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07028
Practice Address - Country:US
Practice Address - Phone:973-746-7474
Practice Address - Fax:973-743-0265
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ35446207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ023248-1OtherUNIVERSITY HEALTH PLAN
NJ221943736OtherUNITED HEALTHCARE
NJ8539520OtherCIGNA
NJ526036OtherAETNA
NJF01046OtherHEALTHNET
NJ000596512OtherAPWU HEALTH PLAN
NJ551535OtherAMERIHEALTH
NJ1040309OtherHORIZON NJ HEALTH
NJ221943736OtherQUALCARE
NJ1523805Medicaid
NJ221943736OtherHORIZON BLUE SHIELD
NJ44J54OtherEMPIRE BLUE
NJCF1767OtherRAIL ROAD MEDICARE
NJP416286OtherOXFORD
NJDA551535Medicare ID - Type Unspecified
NJ221943736OtherQUALCARE