Provider Demographics
NPI:1023471547
Name:FUNSCH, DANIEL G JR (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:FUNSCH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:GERARD
Other - Last Name:FUNSCH
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:885 3RD AVE FL 28
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4834
Mailing Address - Country:US
Mailing Address - Phone:305-771-4986
Mailing Address - Fax:305-771-4986
Practice Address - Street 1:885 3RD AVE FL 28
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4834
Practice Address - Country:US
Practice Address - Phone:305-771-4986
Practice Address - Fax:305-771-4986
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-14489207P00000X
WV29838207P00000X
NJ25MA10444800207P00000X
WY12735A207P00000X
FLME146021207P00000X
NY296346-01207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty