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NPI Code Detail

MEDICARE: MR. DANIEL MAMMON OTR/L

MEDICARE:  MR. DANIEL  MAMMON  OTR/L
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
1225X00000XOccupational Therapist09008-1NY

General Provider Information

NPI Number : 1942477872
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL MAMMON OTR/L
Provider Business Mailing Address
First Line : 14413 70TH AVE
Second Line :
City : FLUSHING
State : NY
Zip : 11367-1713
Country : US
Telephone Number : 718-646-4441
Fax Number :
Provider Business Practice Location Address
First Line : 14413 70TH AVE
Second Line :
City : FLUSHING
State : NY
Zip : 11367-1713
Country : US
Telephone Number : 718-646-4441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2008
Last Update Date : 09/13/2010

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Directions to “ MR. DANIEL MAMMON OTR/L” Practice Location

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