Provider Demographics
NPI:1972927804
Name:CORWIN, DANIEL THOMAS (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:THOMAS
Last Name:CORWIN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SAYLORSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18353-8564
Mailing Address - Country:US
Mailing Address - Phone:484-350-1681
Mailing Address - Fax:
Practice Address - Street 1:225 RIDGE CT
Practice Address - Street 2:
Practice Address - City:SAYLORSBURG
Practice Address - State:PA
Practice Address - Zip Code:18353-8564
Practice Address - Country:US
Practice Address - Phone:484-350-1681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist