Provider Demographics
NPI:1134271133
Name:DANIELS, JESSICA E (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:E
Last Name:DANIELS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:21 MOHAWK TRL
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3206
Mailing Address - Country:US
Mailing Address - Phone:413-340-6011
Mailing Address - Fax:413-345-5961
Practice Address - Street 1:421 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01053-9764
Practice Address - Country:US
Practice Address - Phone:413-584-4040
Practice Address - Fax:413-345-6951
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2023-10-10
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Provider Licenses
StateLicense IDTaxonomies
MA2860172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY309AE1Medicare PIN