MEDICARE: DR. DANIEL JAMES WINARICK PH.D.

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	103TC0700X	Clinical Psychologist	021722	NY
2	103T00000X	Psychologist	021722	NY

General Provider Information

NPI Number	:	1548718828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JAMES WINARICK PH.D.

Provider Business Mailing Address
First Line	:	15 W 72ND ST APT 1L
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-3419
Country	:	US
Telephone Number	:	917-822-8476
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 W 72ND ST APT 1L
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-3419
Country	:	US
Telephone Number	:	917-822-8476
Fax Number	:

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

Provider Enumeration Date	:	09/15/2016
Last Update Date	:	09/22/2023

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