Healthcare Provider Details

I. General information

NPI: 1689106668
Provider Name (Legal Business Name): DANIEL D SINGER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 NICOLLS RD
STONY BROOK NY
11794-0001
US

IV. Provider business mailing address

101 NICOLLS RD, HSC L-4 RM 050
STONY BROOK NY
11794-8350
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-2478
  • Fax:
Mailing address:
  • Phone: 631-444-2478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1689106668
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: