Provider Demographics
NPI:1962494781
Name:NYITRAI, DANIEL D (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:D
Last Name:NYITRAI
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:35670 KENAI SPUR HWY
Mailing Address - Street 2:SUITE 103B
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7626
Mailing Address - Country:US
Mailing Address - Phone:907-262-4357
Mailing Address - Fax:907-262-4390
Practice Address - Street 1:35670 KENAI SPUR HWY
Practice Address - Street 2:SUITE 103B
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7626
Practice Address - Country:US
Practice Address - Phone:907-262-4357
Practice Address - Fax:907-262-4390
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AKAK364363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKRH177FQMedicaid
R02971Medicare UPIN
AKRH177FQMedicaid