MEDICARE: DR. DANIEL J WILKIN DO

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	207Q00000X	Family Medicine Physician	25MB07894000	NJ

General Provider Information

NPI Number	:	1922092121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL J WILKIN DO

Provider Business Mailing Address
First Line	:	680 KINDERKAMACK RD
Second Line	:	SUITE 205
City	:	ORADELL
State	:	NJ
Zip	:	07649-1600
Country	:	US
Telephone Number	:	201-262-0608
Fax Number	:	201-262-8689

Provider Business Practice Location Address
First Line	:	680 KINDERKAMACK RD
Second Line	:	SUITE 205
City	:	ORADELL
State	:	NJ
Zip	:	07649-1600
Country	:	US
Telephone Number	:	201-262-0608
Fax Number	:	201-262-8689

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

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	01/28/2011

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