Provider Demographics
NPI:1336349208
Name:JOHN JOSEPH DANYO JR, M.D.
Entity Type:Organization
Organization Name:JOHN JOSEPH DANYO JR, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DANYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-888-0508
Mailing Address - Street 1:4001 KENNETT PIKE STE 234
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-2029
Mailing Address - Country:US
Mailing Address - Phone:302-888-0508
Mailing Address - Fax:302-888-0509
Practice Address - Street 1:4001 KENNETT PIKE STE 234
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807-2029
Practice Address - Country:US
Practice Address - Phone:302-888-0508
Practice Address - Fax:302-888-0509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10005578174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000939701Medicaid
G96786Medicare UPIN
DE0000939701Medicaid