Provider Demographics
NPI:1831235241
Name:MUSCHEVICI, DAN (MD)
Entity type:Individual
Prefix:DR
First Name:DAN
Middle Name:
Last Name:MUSCHEVICI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W 246TH ST
Mailing Address - Street 2:APT. 1521
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3631
Mailing Address - Country:US
Mailing Address - Phone:646-330-7942
Mailing Address - Fax:
Practice Address - Street 1:OLMMC, DEPT. OF PSYCHIATRY
Practice Address - Street 2:600 EAST 233RD ST.
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466
Practice Address - Country:US
Practice Address - Phone:718-920-9826
Practice Address - Fax:718-920-9217
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2247012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02370354Medicaid
NYH85383Medicare UPIN