Healthcare Provider Details

I. General information

NPI: 1013064377
Provider Name (Legal Business Name): DANIEL HAIMOWITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GARDENIA RD
LEVITTOWN PA
19057-3411
US

IV. Provider business mailing address

1 GARDENIA ROAD
LEVITTOWN PA
19057-3411
US

V. Phone/Fax

Practice location:
  • Phone: 215-943-2222
  • Fax: 215-943-2223
Mailing address:
  • Phone: 215-943-2222
  • Fax: 215-943-2223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD031478E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD031478E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: