Healthcare Provider Details

I. General information

NPI: 1235591520
Provider Name (Legal Business Name): DANIEL ALEJANDRO ESCOBAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 FRANKLIN AVE
VALLEY STREAM NY
11580-2145
US

IV. Provider business mailing address

85 ANDREW RD
MANHASSET NY
11030-2542
US

V. Phone/Fax

Practice location:
  • Phone: 516-256-6000
  • Fax:
Mailing address:
  • Phone: 305-801-5522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number319496
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: