MEDICARE: DR. DANIEL HENNESSEY DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	SC007226	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982212478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL HENNESSEY DPM

Provider Business Mailing Address
First Line	:	699 BEAVER ST UNIT 1142
Second Line	:
City	:	BRISTOL
State	:	PA
Zip	:	19007-3888
Country	:	US
Telephone Number	:	727-403-0333
Fax Number	:

Provider Business Practice Location Address
First Line	:	12401 ACADEMY RD STE 201
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19154-1934
Country	:	US
Telephone Number	:	215-637-3121
Fax Number	:

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

Provider Enumeration Date	:	07/21/2020
Last Update Date	:	09/18/2025

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