Provider Demographics
NPI:1154412138
Name:KAZMIERSKI, DANIEL JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:KAZMIERSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1789 N KEYSER AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-1250
Mailing Address - Country:US
Mailing Address - Phone:570-969-1904
Mailing Address - Fax:570-969-2916
Practice Address - Street 1:1789 N KEYSER AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-1250
Practice Address - Country:US
Practice Address - Phone:570-969-1904
Practice Address - Fax:570-207-5314
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD048304L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11230 E476OtherGEISINGER HEALTH PLAN
PA001245OtherFIRST PRIORITY HEALTHNEPA
PA080041674OtherRAILROAD MEDICARE
PA734400OtherFIRST PRIORITY LIFE
PA0014126800001Medicaid
PA010175800OtherBLACK LUNG
PA0536755OtherAETNA
PA242159OtherHEALTH AMERICA
PA0536755OtherUNITED HEALTHCARE
PA0638250000OtherPABS PERSONAL CHOICE
PA11230 E476OtherGEISINGER GOLD
PA734400OtherPA BLUESHIELD
PAF52043OtherSTERLING