Basic Information
Provider Information
NPI: 1841647823
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DANIEL
FirstName: JOSHUA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 E. NEW YORK AVE
Address2: 4TH FLOOR - SPG
City: SOMERS POINT
State: NJ
PostalCode: 08244
CountryCode: US
TelephoneNumber: 6096533994
FaxNumber: 6099264311
Practice Location
Address1: 52 E NEW YORK AVE
Address2:  
City: SOMERS POINT
State: NJ
PostalCode: 082442380
CountryCode: US
TelephoneNumber: 6093656202
FaxNumber: 6096531934
Other Information
ProviderEnumerationDate: 05/19/2016
LastUpdateDate: 02/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400XP13-00368NJY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


Home