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NPI Code Detail

MEDICARE: MR. DANIEL J SANZA MSPAS, PA-C

MEDICARE: MR. DANIEL J SANZA MSPAS, PA-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
1363A00000XPhysician Assistant0010-05271NC

General Provider Information

NPI Number : 1487092193
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL J SANZA MSPAS, PA-C
Provider Business Mailing Address
First Line : 708 S CHESTNUT ST
Second Line :
City : GASTONIA
State : NC
Zip : 28054-4548
Country : US
Telephone Number : 704-864-6444
Fax Number : 704-864-6448
Provider Business Practice Location Address
First Line : 1705 TARBORO ST SW
Second Line :
City : WILSON
State : NC
Zip : 27893-3437
Country : US
Telephone Number : 252-399-8040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2013
Last Update Date : 01/05/2023

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