Provider Demographics
NPI:1518241488
Name:HARTSTEIN, DANIEL JOHN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOHN
Last Name:HARTSTEIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58887 SPRING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46516-6272
Mailing Address - Country:US
Mailing Address - Phone:574-293-2063
Mailing Address - Fax:574-522-2483
Practice Address - Street 1:58887 SPRING CREEK TRL
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516-6272
Practice Address - Country:US
Practice Address - Phone:574-293-2063
Practice Address - Fax:574-522-2483
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023480A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist