Provider Demographics
NPI:1396784120
Name:SHRAGER, DANIEL ISRAEL (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ISRAEL
Last Name:SHRAGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:670 LAWN AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1571
Mailing Address - Country:US
Mailing Address - Phone:215-257-0196
Mailing Address - Fax:215-257-1211
Practice Address - Street 1:670 LAWN AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1571
Practice Address - Country:US
Practice Address - Phone:215-257-0196
Practice Address - Fax:215-257-1211
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07404700207N00000X
PAMD062497L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA132717YYNUMedicare PIN
NJ337101YYKLMedicare PIN