Provider Demographics
NPI:1700989852
Name:HOLLAND, DANIEL JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:HOLLAND
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 1:12 KING RD
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-3019
Mailing Address - Country:US
Mailing Address - Phone:516-650-5117
Mailing Address - Fax:
Practice Address - Street 1:62 LAKE AVE S
Practice Address - Street 2:SUITE C
Practice Address - City:NESCONSET
Practice Address - State:NY
Practice Address - Zip Code:11767-1094
Practice Address - Country:US
Practice Address - Phone:631-584-8783
Practice Address - Fax:631-584-8784
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor