Provider Demographics
NPI:1750195814
Name:DANIEL, ANITHA MARY (FNP-C)
Entity type:Individual
Prefix:
First Name:ANITHA
Middle Name:MARY
Last Name:DANIEL
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 ROUTE 17M
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-5231
Mailing Address - Country:US
Mailing Address - Phone:845-294-1234
Mailing Address - Fax:845-294-7583
Practice Address - Street 1:1995 ROUTE 17M
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-5231
Practice Address - Country:US
Practice Address - Phone:845-294-1234
Practice Address - Fax:845-294-7583
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF354991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily