Provider Demographics
NPI:1063485969
Name:MASSIAH, DANIEL COLIN (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:COLIN
Last Name:MASSIAH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1333 ROANOKE AVE SUITE 202
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901
Mailing Address - Country:US
Mailing Address - Phone:631-591-3877
Mailing Address - Fax:631-591-3880
Practice Address - Street 1:1333 ROANOKE AVE SUITE 202
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901
Practice Address - Country:US
Practice Address - Phone:631-591-3877
Practice Address - Fax:631-591-3880
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235602207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY12388304OtherMULTIPLAN
NY235602-0WOtherWORKER'S COMPENSATION
NY8V044OtherBCBS
NY8V2021OtherBCBS
NY1861894OtherCIGNA
NYP00260961OtherRAILROAD MEDICARE
NY8V044OtherBCBS
NYI30251Medicare UPIN