Provider Demographics
NPI:1316093628
Name:ASNES, DANIEL PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL
Last Name:ASNES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MOUNT AUBURN ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5600
Mailing Address - Country:US
Mailing Address - Phone:617-497-5608
Mailing Address - Fax:
Practice Address - Street 1:300 MOUNT AUBURN ST
Practice Address - Street 2:SUITE 307
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5600
Practice Address - Country:US
Practice Address - Phone:617-497-5608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA327542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB07111Medicare ID - Type UnspecifiedMEDICARE AND BLUE SHIELD