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NPI Code Detail

MEDICARE: MR. KYLE-HASHIM DANIELS APRN

MEDICARE: MR. KYLE-HASHIM DANIELS APRN
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
1363LF0000XFamily Nurse Practitioner9045CT

General Provider Information

NPI Number : 1962016816
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KYLE-HASHIM DANIELS APRN
Provider Business Mailing Address
First Line : 603 WHALLEY AVE
Second Line :
City : NEW HAVEN
State : CT
Zip : 06511-2910
Country : US
Telephone Number : 203-627-3296
Fax Number :
Provider Business Practice Location Address
First Line : 275 MOUNT CARMEL AVE
Second Line :
City : HAMDEN
State : CT
Zip : 06518-1908
Country : US
Telephone Number : 203-582-8742
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2020
Last Update Date : 09/08/2020

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