Provider Demographics
NPI:1306068952
Name:DANIELE, JOAN O'DONNELL (PHD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:O'DONNELL
Last Name:DANIELE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JOAN
Other - Middle Name:PATRICIA
Other - Last Name:O'DONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:250 W 90TH ST
Mailing Address - Street 2:SUITE 6I
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1100
Mailing Address - Country:US
Mailing Address - Phone:212-595-6962
Mailing Address - Fax:
Practice Address - Street 1:250 W 90TH ST
Practice Address - Street 2:SUITE 6I
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1100
Practice Address - Country:US
Practice Address - Phone:212-595-6962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10372103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV71221Medicare ID - Type Unspecified