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General NPI Number Information
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NPI Number | 1275690307
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Entity Type | Organization
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Legal Business Name | KENNETH DANIELS, O.D., P.C.
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 84 E BROAD ST
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City | HOPEWELL
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State | NJ
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Zip | 08525-1820
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Country | US
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Telephone | 609-466-0055
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3560
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City | PRINCETON
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State | NJ
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Zip | 08543-3560
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Country | US
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Telephone | 609-514-0663
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH MARTIN DANIELS
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Credential | O.D.
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Telephone | 609-466-0055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 27OA00491300
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License Number State | NJ
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