Provider Demographics
NPI:1811038854
Name:BEIDLEMAN, DANIELLE MELISSA (MD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MELISSA
Last Name:BEIDLEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MELISSA
Other - Last Name:ARUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:362 DEMOTT AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3128
Mailing Address - Country:US
Mailing Address - Phone:347-482-7422
Mailing Address - Fax:
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:DEPARTMENT OF OB/GYN
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242460207V00000X
NJ#25MA08431400207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02851976Medicaid