Provider Demographics
NPI:1821060047
Name:TREMENTOZZI, DANIEL P (MD01/08/1967)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:TREMENTOZZI
Suffix:
Gender:M
Credentials:MD01/08/1967
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Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:LADYSMITH
Mailing Address - State:VA
Mailing Address - Zip Code:22501-0216
Mailing Address - Country:US
Mailing Address - Phone:804-448-1380
Mailing Address - Fax:804-448-9571
Practice Address - Street 1:18048 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:RUTHER GLEN
Practice Address - State:VA
Practice Address - Zip Code:22546-2922
Practice Address - Country:US
Practice Address - Phone:804-448-1380
Practice Address - Fax:804-448-9571
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101231223208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H39025Medicare UPIN