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NPI Code Detail

MEDICARE: DR. DANIEL P BULLOCK MD

MEDICARE: DR. DANIEL P BULLOCK MD
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
1207X00000XOrthopaedic Surgery Physician46697CO
2207X00000XOrthopaedic Surgery Physician252452NY

General Provider Information

NPI Number : 1366544017
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL P BULLOCK MD
Provider Business Mailing Address
First Line : 203 OLD MILITARY RD
Second Line :
City : LAKE PLACID
State : NY
Zip : 12946-1738
Country : US
Telephone Number : 518-523-1327
Fax Number : 518-523-9964
Provider Business Practice Location Address
First Line : 203 OLD MILITARY RD
Second Line :
City : LAKE PLACID
State : NY
Zip : 12946-1738
Country : US
Telephone Number : 518-523-1327
Fax Number : 518-523-9964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2006
Last Update Date : 03/30/2021

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