Provider Demographics
NPI:1922423094
Name:DANIELS, JAMES HAWKINS III (LMT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HAWKINS
Last Name:DANIELS
Suffix:III
Gender:M
Credentials:LMT
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Mailing Address - Street 1:1019 STATE ROUTE 17M
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1643
Mailing Address - Country:US
Mailing Address - Phone:845-781-5890
Mailing Address - Fax:516-599-2185
Practice Address - Street 1:1019 STATE ROUTE 17M
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1643
Practice Address - Country:US
Practice Address - Phone:845-781-5890
Practice Address - Fax:516-599-2185
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY025942-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY025942-1OtherSTATE LICENSE