Provider Demographics
NPI:1285084947
Name:CRAIGG, DANIELLE KRISTIN (MD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:KRISTIN
Last Name:CRAIGG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NICOLLS RD
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8434
Mailing Address - Country:US
Mailing Address - Phone:631-444-3936
Mailing Address - Fax:631-444-7525
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8434
Practice Address - Country:US
Practice Address - Phone:631-444-3936
Practice Address - Fax:631-444-7525
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY325013-012083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program