Provider Demographics
NPI:1922006832
Name:CHARNOFF, DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:CHARNOFF
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 1:2985 QUENTIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1839
Mailing Address - Country:US
Mailing Address - Phone:718-376-5553
Mailing Address - Fax:718-645-2228
Practice Address - Street 1:2985 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1839
Practice Address - Country:US
Practice Address - Phone:718-376-5553
Practice Address - Fax:718-645-2228
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143191207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY007963968Medicaid
NY007963968Medicaid
11E261Medicare PIN