Healthcare Provider Details

I. General information

NPI: 1740581941
Provider Name (Legal Business Name): DANILYNN GONZALES DE CLARO M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2010
Last Update Date: 12/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27005 76TH AVE
NEW HYDE PARK NY
11040-1402
US

IV. Provider business mailing address

7928 258TH ST
GLEN OAKS NY
11004-1232
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-3772
  • Fax:
Mailing address:
  • Phone: 917-426-6639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number266745
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number266745
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number266745
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: