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General NPI Number Information
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NPI Number | 1255140596
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Entity Type | Individual
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Provider Name | DANIEL HEISER R.R.A RT(R) VI
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Gender | Male
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 630 W 168TH ST
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City | NEW YORK
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State | NY
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Zip | 10032-3725
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Country | US
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Telephone | 646-846-4616
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Fax |
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Provider Business Mailing Address
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Address Line | 441 S DILLARD ST APT 102
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City | DURHAM
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State | NC
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Zip | 27701-4946
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Country | US
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Telephone | 571-213-1702
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471V0106X
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Taxonomy Name | Vascular-Interventional Technology Radiologic Technologist
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License Number | 448228
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License Number State | NC
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