Healthcare Provider Details

I. General information

NPI: 1306375381
Provider Name (Legal Business Name): DANIEL J POMERANTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 02/15/2025
Certification Date: 02/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2621
US

IV. Provider business mailing address

711 HARVEST HILL DR
CHALFONT PA
18914-1526
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-1561
  • Fax:
Mailing address:
  • Phone: 12155148115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number288459
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number288459
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: