Provider Demographics
NPI:1194700047
Name:MENDEZ METZ, DANAE R (MD)
Entity type:Individual
Prefix:DR
First Name:DANAE
Middle Name:R
Last Name:MENDEZ METZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:DANAE
Other - Middle Name:MENDEZ
Other - Last Name:ARRIOLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1167
Practice Address - Country:US
Practice Address - Phone:717-242-7283
Practice Address - Fax:717-242-8965
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4213632085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL046698100Medicaid
FL046698100Medicaid
FL96625WMedicare ID - Type Unspecified