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General NPI Number Information
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NPI Number | 1780887513
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Entity Type | Organization
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Legal Business Name | ANDREW W. DANYLUK MD PC
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 04/22/2009
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Provider Practice Location Address
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Address Line | 777 NORTH ST 3RD FLOOR
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City | PITTSFIELD
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State | MA
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Zip | 01201-4147
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Country | US
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Telephone | 413-499-6405
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Fax | 413-442-7118
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Provider Business Mailing Address
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Address Line | PO BOX 1490
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City | LANESBORO
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State | MA
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Zip | 01237-1490
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Country | US
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Telephone | 413-499-6405
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Fax | 413-442-7118
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW W DANYLUK
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Credential | MD
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Telephone | 413-499-6405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 79169
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License Number State | MA
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