Provider Demographics
NPI:1174082143
Name:DANIEL, ASHLEY D (DPM)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:D
Last Name:DANIEL
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Gender:F
Credentials:DPM
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Mailing Address - Street 1:960 MASSACHUSETTS AVENUE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:732 HARRISON AVENUE, 5TH FLOOR
Practice Address - Street 2:PRESTON BLDG.
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-414-6840
Practice Address - Fax:617-414-6710
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2024-04-03
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Provider Licenses
StateLicense IDTaxonomies
MA2534213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3143949Medicaid
MA110157841AMedicaid