MEDICARE: DR. DANIELLE M DANZI DDS

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	1223G0001X	General Practice Dentistry	DEN02840	RI

General Provider Information

NPI Number	:	1598731184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE M DANZI DDS

Provider Business Mailing Address
First Line	:	301 E 38TH ST
Second Line	:	APT 5C
City	:	NEW YORK
State	:	NY
Zip	:	10016-2750
Country	:	US
Telephone Number	:	646-387-8120
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 BROADWAY
Second Line	:	SUITE 1310
City	:	NEW YORK
State	:	NY
Zip	:	10038-4381
Country	:	US
Telephone Number	:	212-587-0202
Fax Number	:	212-587-8829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	07/08/2007

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