Provider Demographics
NPI:1487092193
Name:SANZA, DANIEL J (MSPAS, PA-C)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:SANZA
Suffix:
Gender:M
Credentials:MSPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:708 S CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-4548
Mailing Address - Country:US
Mailing Address - Phone:704-864-6444
Mailing Address - Fax:704-864-6448
Practice Address - Street 1:1705 TARBORO ST SW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3437
Practice Address - Country:US
Practice Address - Phone:252-399-8040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-05271363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant