MEDICARE: DANIEL G HERBOWY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier	N002813	NY
2	332B00000X	Durable Medical Equipment & Medical Supplies	N002813	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1065540002	OTHER		DMERC

General Provider Information

NPI Number	:	1003273194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL G HERBOWY

Provider Business Mailing Address
First Line	:	208 BITTERN CT
Second Line	:
City	:	NEW HARTFORD
State	:	NY
Zip	:	13413-3516
Country	:	US
Telephone Number	:	315-525-7087
Fax Number	:	315-793-3149

Provider Business Practice Location Address
First Line	:	4340 MIDDLE SETTLEMENT RD
Second Line	:
City	:	NEW HARTFORD
State	:	NY
Zip	:	13413-5316
Country	:	US
Telephone Number	:	315-738-7772
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL HERBOWY
Credential	:	DPM
Telephone Number	:	315-525-7087

Provider Enumeration Date	:	01/21/2016
Last Update Date	:	01/30/2018

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