Provider Demographics
NPI:1740365949
Name:BASH, DANIEL EDWIN (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EDWIN
Last Name:BASH
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 1:1022 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1676
Mailing Address - Country:US
Mailing Address - Phone:724-465-2225
Mailing Address - Fax:724-465-2225
Practice Address - Street 1:1022 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-1676
Practice Address - Country:US
Practice Address - Phone:724-465-2225
Practice Address - Fax:724-465-2225
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003723L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011520520002Medicaid
PAU01422Medicare UPIN