Provider Demographics
NPI:1912903493
Name:BASH, DANIEL STEVEN (MS, OTRL, CHT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:STEVEN
Last Name:BASH
Suffix:
Gender:M
Credentials:MS, OTRL, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6225 MAIN ST
Mailing Address - Street 2:COOPER BONE & JOINT INSTITUTE
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4629
Mailing Address - Country:US
Mailing Address - Phone:856-325-6774
Mailing Address - Fax:856-325-6649
Practice Address - Street 1:6225 MAIN STREET COMPLEX
Practice Address - Street 2:COOPER BONE & JOINT INSTITUTE
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-325-6674
Practice Address - Fax:856-325-6649
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00000400225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2375048000OtherAMERIHEALTH/KEYSTONE/IBC
NJ1095339OtherAETNA
2767094OtherUNITED HEALTHCARE
NJ1704609OtherAMERIHEALTH PPO/PA BS
NJ2888206OtherCIGNA
NJ086291DSTMedicare PIN