Basic Information
Provider Information
NPI: 1851940423
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUBROW
FirstName: DANIEL
MiddleName: ASHER
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 179 LODI WAY
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152013234
CountryCode: US
TelephoneNumber: 2035358587
FaxNumber:  
Practice Location
Address1: 400 N PEPPER AVE STE 107
Address2:  
City: COLTON
State: CA
PostalCode: 923241819
CountryCode: US
TelephoneNumber: 9095801000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/06/2019
LastUpdateDate: 09/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X57187CAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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