MEDICARE: DR. DAIJI KANO M.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	208600000X	Surgery Physician	25MA11791700	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972958213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAIJI KANO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 416457
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-6457
Country	:	US
Telephone Number	:	844-362-1735
Fax Number	:	973-290-7495

Provider Business Practice Location Address
First Line	:	155 MORRIS AVE STE 204
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-1224
Country	:	US
Telephone Number	:	973-232-2300
Fax Number	:	973-232-2301

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

Provider Enumeration Date	:	04/24/2016
Last Update Date	:	09/01/2023

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Directions to “ DR. DAIJI KANO M.D.” Practice Location

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