Provider Demographics
NPI:1922252238
Name:DANZIG, LOUISE M (NP)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:M
Last Name:DANZIG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRADHURST AVE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-594-4370
Mailing Address - Fax:914-594-4513
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:SUITE 1400
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-594-4370
Practice Address - Fax:914-594-4513
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380008-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03055272Medicaid
NYA400007435Medicare PIN
NYA400007436Medicare PIN