Provider Demographics
NPI:1366993552
Name:DANIELS DYNASTY, INC.
Entity type:Organization
Organization Name:DANIELS DYNASTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-342-0069
Mailing Address - Street 1:151 W 123RD ST
Mailing Address - Street 2:APT 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-5519
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:212-662-1695
Practice Address - Street 1:151 W 123RD ST
Practice Address - Street 2:APT 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-5519
Practice Address - Country:US
Practice Address - Phone:646-342-0069
Practice Address - Fax:212-662-1695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-22
Last Update Date:2016-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable