Provider Demographics
NPI:1750483236
Name:POWSNER, DANIEL J (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:POWSNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NA
Other - Middle Name:
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1150 5TH AVE
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0724
Mailing Address - Country:US
Mailing Address - Phone:212-534-0868
Mailing Address - Fax:718-831-0368
Practice Address - Street 1:1150 5TH AVE
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0724
Practice Address - Country:US
Practice Address - Phone:212-534-0868
Practice Address - Fax:718-831-0368
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1241732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
15A273Medicare ID - Type Unspecified
B04768Medicare UPIN