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General NPI Number Information
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NPI Number | 1255504767
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Entity Type | Organization
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Legal Business Name | DANIEL JOSEPHTHAL MD INC
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Dates
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Enumeration Date | 04/04/2008
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Last Update Date | 04/04/2008
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Provider Practice Location Address
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Address Line | 503 FAULCONER DR #4A
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-4978
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Country | US
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Telephone | 434-977-3621
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Fax | 434-984-2122
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Provider Business Mailing Address
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Address Line | 503 FAULCONER DR #4A
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-4978
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Country | US
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Telephone | 434-977-3621
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Fax | 434-984-2122
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. DANIEL H JOSEPHTHAL
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Credential | MD
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Telephone | 434-977-3621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101017267
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License Number State | VA
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