Provider Demographics
NPI:1104311844
Name:MCELROY, DANIEL VINCENT (FNP-C)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:VINCENT
Last Name:MCELROY
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 THURSTON TER
Mailing Address - Street 2:
Mailing Address - City:SHERRILL
Mailing Address - State:NY
Mailing Address - Zip Code:13461-1278
Mailing Address - Country:US
Mailing Address - Phone:315-725-3698
Mailing Address - Fax:
Practice Address - Street 1:1508 GENESEE ST STE 1
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5178
Practice Address - Country:US
Practice Address - Phone:315-798-8737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY343182OtherLICENSE