Healthcare Provider Details

I. General information

NPI: 1831464718
Provider Name (Legal Business Name): DANIEL MELVIN HUBER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 05/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PINE WEST PLZ STE 511
ALBANY NY
12205-5587
US

IV. Provider business mailing address

5 PINE WEST PLZ STE 512
ALBANY NY
12205-5587
US

V. Phone/Fax

Practice location:
  • Phone: 518-248-9338
  • Fax:
Mailing address:
  • Phone: 518-248-9338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number019516
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: