Provider Demographics
NPI:1861499147
Name:FOITL, DANIEL ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROBERT
Last Name:FOITL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 E 58TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2302
Mailing Address - Country:US
Mailing Address - Phone:212-838-0270
Mailing Address - Fax:212-753-5329
Practice Address - Street 1:445 E 58TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2302
Practice Address - Country:US
Practice Address - Phone:212-838-0270
Practice Address - Fax:212-753-5329
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175720207N00000X, 207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
553291OtherAETNA
NS4331OtherOXFORD
1730213943OtherGROUP NPI
553291OtherAETNA
1730213943OtherGROUP NPI