MEDICARE: DR. DANIEL HOUSHMAND D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	38MC00567300	NJ

General Provider Information

NPI Number	:	1265439277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL HOUSHMAND D.C.

Provider Business Mailing Address
First Line	:	96 MILLBURN AVE
Second Line	:	SUITE #101
City	:	MILLBURN
State	:	NJ
Zip	:	07041-1944
Country	:	US
Telephone Number	:	973-378-2003
Fax Number	:	973-378-2037

Provider Business Practice Location Address
First Line	:	96 MILLBURN AVE
Second Line	:	SUITE #101
City	:	MILLBURN
State	:	NJ
Zip	:	07041-1944
Country	:	US
Telephone Number	:	973-378-2003
Fax Number	:	973-378-2037

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/09/2007

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