MEDICARE: KIMBERLY DANIEL

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	252Y00000X	Early Intervention Provider Agency
2	174400000X	Specialist

General Provider Information

NPI Number	:	1952782849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY DANIEL

Provider Business Mailing Address
First Line	:	129 W 147TH ST
Second Line	:	7B
City	:	NEW YORK
State	:	NY
Zip	:	10039-4303
Country	:	US
Telephone Number	:	646-488-7732
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 W 147TH ST
Second Line	:	7B
City	:	NEW YORK
State	:	NY
Zip	:	10039-4303
Country	:	US
Telephone Number	:	646-488-7732
Fax Number	:

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

Provider Enumeration Date	:	06/16/2015
Last Update Date	:	06/26/2025

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Directions to “ KIMBERLY DANIEL ” Practice Location

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