Provider Demographics
NPI:1104450899
Name:DANIEL, PRIYA MARY (NP)
Entity type:Individual
Prefix:MRS
First Name:PRIYA
Middle Name:MARY
Last Name:DANIEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:PRIYA
Other - Middle Name:MARY
Other - Last Name:PETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:77 VERONICA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-6804
Mailing Address - Country:US
Mailing Address - Phone:732-246-1311
Mailing Address - Fax:833-914-0459
Practice Address - Street 1:77 VERONICA AVE STE 102
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-6804
Practice Address - Country:US
Practice Address - Phone:732-246-1311
Practice Address - Fax:833-914-0459
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF345697-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily