Provider Demographics
NPI:1891700670
Name:BRENINGHOUSE, DANIEL A JR (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:BRENINGHOUSE
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-6002
Mailing Address - Country:US
Mailing Address - Phone:215-891-9955
Mailing Address - Fax:215-891-9655
Practice Address - Street 1:2440 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-6002
Practice Address - Country:US
Practice Address - Phone:215-891-9955
Practice Address - Fax:215-891-9655
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007453-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA07722886Medicaid
PA046540Medicare ID - Type Unspecified
PAU74057Medicare UPIN