Provider Demographics
NPI:1104141332
Name:SONNTAG, DANIEL (LMT, CAT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:SONNTAG
Suffix:
Gender:M
Credentials:LMT, CAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8339 116TH ST
Mailing Address - Street 2:APT 6A
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418
Mailing Address - Country:US
Mailing Address - Phone:718-607-5062
Mailing Address - Fax:509-356-3993
Practice Address - Street 1:119-29 80TH ROAD #A
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415
Practice Address - Country:US
Practice Address - Phone:718-607-5062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist