Provider Demographics
NPI:1366604068
Name:CORREA, DANIEL JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSE
Last Name:CORREA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:111 E 210 STREET
Mailing Address - Street 2:MONTEFIORE MEDICAL CENTER, EPILEPSY CENTER
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-5650
Mailing Address - Country:US
Mailing Address - Phone:718-430-2447
Mailing Address - Fax:718-430-8899
Practice Address - Street 1:111 E 210 STREET
Practice Address - Street 2:MONTEFIORE MEDICAL CENTER, EPILEPSY CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10467-1046
Practice Address - Country:US
Practice Address - Phone:718-430-2447
Practice Address - Fax:718-430-8899
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
NY2907032084N0400X
VA01012478542084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology