Provider Demographics
NPI:1730603960
Name:ALBIANI-GROSS, DANIEL JOHN (EMT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOHN
Last Name:ALBIANI-GROSS
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5216 MARIE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-9593
Mailing Address - Country:US
Mailing Address - Phone:716-525-3514
Mailing Address - Fax:
Practice Address - Street 1:5216 MARIE CT
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-9593
Practice Address - Country:US
Practice Address - Phone:716-525-3514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY432725146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY432725OtherAEMT