Healthcare Provider Details

I. General information

NPI: 1538114210
Provider Name (Legal Business Name): DANIEL PAKNIA D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WEST ST SUITE 7
WEST HATFIELD MA
01088-9554
US

IV. Provider business mailing address

PO BOX 76
HATFIELD MA
01038-0076
US

V. Phone/Fax

Practice location:
  • Phone: 413-397-8900
  • Fax:
Mailing address:
  • Phone: 413-219-9813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2307
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: