Provider Demographics
NPI:1952627366
Name:WALES, DANIELLE PATRICIA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:PATRICIA
Last Name:WALES
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1019 NEW LOUDON RD DEPT OF
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-5003
Mailing Address - Country:US
Mailing Address - Phone:518-262-7500
Mailing Address - Fax:518-262-7505
Practice Address - Street 1:1019 NEW LOUDON RD DEPT OF
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-5003
Practice Address - Country:US
Practice Address - Phone:518-262-7500
Practice Address - Fax:518-262-7505
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY269252208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics