Provider Demographics
NPI:1720583347
Name:REUBENS, DANIEL BRADEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BRADEN
Last Name:REUBENS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 OLD JONESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-2607
Mailing Address - Country:US
Mailing Address - Phone:171-754-1098
Mailing Address - Fax:
Practice Address - Street 1:6100 OLD JONESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2607
Practice Address - Country:US
Practice Address - Phone:717-541-0988
Practice Address - Fax:717-412-4882
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-007313213EP1101X, 213ES0103X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program