Provider Demographics
NPI:1821205691
Name:DANIEL O. DADA, M.D., PC
Entity type:Organization
Organization Name:DANIEL O. DADA, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:DADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-874-6553
Mailing Address - Street 1:230 E 24TH ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-4634
Mailing Address - Country:US
Mailing Address - Phone:610-874-6553
Mailing Address - Fax:610-874-6653
Practice Address - Street 1:230 E 24TH ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4634
Practice Address - Country:US
Practice Address - Phone:610-874-6553
Practice Address - Fax:610-874-6653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030353-E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10008OtherKEYSTONE MERCY INDIVIDUAL
PA1131505OtherKEYSTONE MERCY-GROUP
PA0031509000OtherPERS. CHOICE-INDIVIDUAL
PA0092891304OtherAMERICHOICE OF PA
PA0784853000OtherPERSONAL CHOICE-GROUP
PA4315464OtherAETNA INDIVIDUAL
PA538590OtherAETNA GROUP ID
PA0031509000OtherKEYSTONE EAST-INDIVIDUAL
PA0784853001OtherKEYSTONE EAST-GROUP
PA0009289130004Medicaid
PA0009289130004Medicaid
PA=========OtherUNITED HEALTHCARE
PA=========OtherAMERIHEALTH ADMINISTRATOR
PA1131505OtherKEYSTONE MERCY-GROUP