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NPI Code Detail

MEDICARE: RICHARD J DANIELS MD

MEDICARE:   RICHARD J DANIELS  MD
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
12085R0204XVascular & Interventional Radiology Physician4301510207MI
22086S0129XVascular Surgery PhysicianMD057930LPA
32086S0129XVascular Surgery Physician25MA06910800NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11172539OTHERPAAETNA HMO
25398994OTHERPACIGNA HMO/PPO
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
42100067000OTHERPAAMERIHEALTH/INTERCOUNTY
530026847OTHERPAKEYSTONE MERCY
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
71413260OTHERPAHIGHMARK BLUE SHIELD
82100067000OTHERPAIBC - PC/KHPE
97034415OTHERPAAETNA PPO

General Provider Information

NPI Number : 1417905043
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD J DANIELS MD
Provider Business Mailing Address
First Line : PO BOX 5220
Second Line :
City : TOMS RIVER
State : NJ
Zip : 08754-5220
Country : US
Telephone Number : 732-349-3838
Fax Number : 732-349-2233
Provider Business Practice Location Address
First Line : 54 BEY LEA RD
Second Line : SUITE 1
City : TOMS RIVER
State : NJ
Zip : 08753-2978
Country : US
Telephone Number : 732-616-1801
Fax Number : 215-744-6724
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 06/06/2024

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