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General NPI Number Information
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NPI Number | 1720604622
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Entity Type | Individual
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Provider Name | MR. MATTHEW JOSEPH DANIS
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Gender | Male
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 1178 BROADWAY, 3RD FLOOR SUITE #3813
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City | NEW YORK
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State | NY
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Zip | 10001
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Country | US
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Telephone | 917-696-1956
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Fax |
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Provider Business Mailing Address
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Address Line | 35 W 87TH ST APT 4B
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City | NEW YORK
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State | NY
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Zip | 10024-3060
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 107974
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License Number State | NY
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