Provider Demographics
NPI:1366182826
Name:DANIEL, TANISHA DEE (MD)
Entity type:Individual
Prefix:
First Name:TANISHA
Middle Name:DEE
Last Name:DANIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BRIDLE CT
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5354
Mailing Address - Country:US
Mailing Address - Phone:908-884-3245
Mailing Address - Fax:
Practice Address - Street 1:14 BRIDLE CT
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5354
Practice Address - Country:US
Practice Address - Phone:908-884-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-31
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program