Provider Demographics
NPI:1194711267
Name:REIDA, DANIEL J (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:REIDA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:833 MAIN ST
Mailing Address - Street 2:ROUTE 28
Mailing Address - City:SOUTH YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02664-5254
Mailing Address - Country:US
Mailing Address - Phone:508-394-1353
Mailing Address - Fax:508-398-2866
Practice Address - Street 1:833 MAIN ST
Practice Address - Street 2:ROUTE 28
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-5254
Practice Address - Country:US
Practice Address - Phone:508-394-1353
Practice Address - Fax:508-398-2866
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1603752Medicaid
MA729293OtherTUFTS HEALTHPLAN
MA35260OtherHARVARD PILGRIM HEALTHCAR
MAY35064OtherBCBS OF MA
MA729293OtherTUFTS HEALTHPLAN
MA1603752Medicaid