Healthcare Provider Details

I. General information

NPI: 1073791067
Provider Name (Legal Business Name): DORIS JULIA DANKO MD MA MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 05/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CLARA MAASS DR
BELLEVILLE NJ
07109-3550
US

IV. Provider business mailing address

14 RIVER DELL
OAKLAND NJ
07436-2300
US

V. Phone/Fax

Practice location:
  • Phone: 973-450-2175
  • Fax: 973-844-4779
Mailing address:
  • Phone: 201-337-8812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License NumberMA 66092
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: