Provider Demographics
NPI:1942274683
Name:DANIELSON, VALERIE J (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:J
Last Name:DANIELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 HOLT AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-5603
Mailing Address - Country:US
Mailing Address - Phone:603-693-2100
Mailing Address - Fax:603-697-1046
Practice Address - Street 1:212 CALEF HWY
Practice Address - Street 2:
Practice Address - City:EPPING
Practice Address - State:NH
Practice Address - Zip Code:03042-2322
Practice Address - Country:US
Practice Address - Phone:603-693-2100
Practice Address - Fax:603-697-1046
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3074394Medicaid
NH3074394Medicaid
NHT400272493Medicare PIN
NH1082517OtherAETNA PIN
NHAA13816OtherHARVARD PILGRIM PIN
NH9147189OtherCIGNA PIN
NH01YP05098NH02OtherANTHEM BCBS PIN
NH30315YOtherANTHEM REFERRING RAN
NHRE7376Medicare PIN