Provider Demographics
NPI:1083871412
Name:AZERRAD, DANNY DAVID (FNP)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:DAVID
Last Name:AZERRAD
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 STEVEN DR
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1008
Mailing Address - Country:US
Mailing Address - Phone:917-533-3893
Mailing Address - Fax:915-975-8171
Practice Address - Street 1:1 STEVEN DR
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1008
Practice Address - Country:US
Practice Address - Phone:917-533-3893
Practice Address - Fax:915-975-8171
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC10000713174400000X
CERT058361744R1102X
NY355744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No174400000XOther Service ProvidersSpecialist
No1744R1102XOther Service ProvidersSpecialistResearch Study