Healthcare Provider Details

I. General information

NPI: 1063876696
Provider Name (Legal Business Name): DANIELLE DESPRES DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2016
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E 95TH ST
NEW YORK NY
10128-4077
US

IV. Provider business mailing address

55 WATER ST FL 2
NEW YORK NY
10041-0010
US

V. Phone/Fax

Practice location:
  • Phone: 212-996-8000
  • Fax: 212-423-3467
Mailing address:
  • Phone: 646-680-2888
  • Fax: 516-542-5556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN007014
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: