Healthcare Provider Details

I. General information

NPI: 1831235241
Provider Name (Legal Business Name): DAN MUSCHEVICI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OLMMC, DEPT. OF PSYCHIATRY 600 EAST 233RD ST.
BRONX NY
10466
US

IV. Provider business mailing address

630 W 246TH ST APT. 1521
BRONX NY
10471-3631
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-9826
  • Fax: 718-920-9217
Mailing address:
  • Phone: 646-330-7942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number224701
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: