Basic Information
| Provider Information | |||||||||
| NPI: | 1689668683 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DANISKAS | ||||||||
| FirstName: | EFTHYMIOS | ||||||||
| MiddleName: | I | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 419430 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022419430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019678221 | ||||||||
| FaxNumber: | 2014832242 | ||||||||
| Practice Location | |||||||||
| Address1: | 311 BAY AVE | ||||||||
| Address2: | MMG PULMONOLOGY | ||||||||
| City: | GLEN RIDGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9737467474 | ||||||||
| FaxNumber: | 9737430265 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2005 | ||||||||
| LastUpdateDate: | 06/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 35446 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 023248-1 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 221943736 | 01 | NJ | UNITED HEALTHCARE | OTHER | 8539520 | 01 | NJ | CIGNA | OTHER | 526036 | 01 | NJ | AETNA | OTHER | F01046 | 01 | NJ | HEALTHNET | OTHER | 000596512 | 01 | NJ | APWU HEALTH PLAN | OTHER | 551535 | 01 | NJ | AMERIHEALTH | OTHER | 1040309 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 221943736 | 01 | NJ | QUALCARE | OTHER | 1523805 | 05 | NJ | MEDICAID | 221943736 | 01 | NJ | HORIZON BLUE SHIELD | OTHER | 44J54 | 01 | NJ | EMPIRE BLUE | OTHER | CF1767 | 01 | NJ | RAIL ROAD MEDICARE | OTHER | P416286 | 01 | NJ | OXFORD | OTHER |