Provider Demographics
NPI:1265439277
Name:HOUSHMAND, DANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:HOUSHMAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 MILLBURN AVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1944
Mailing Address - Country:US
Mailing Address - Phone:973-378-2003
Mailing Address - Fax:973-378-2037
Practice Address - Street 1:96 MILLBURN AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1944
Practice Address - Country:US
Practice Address - Phone:973-378-2003
Practice Address - Fax:973-378-2037
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00567300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU89337Medicare UPIN