Provider Demographics
NPI:1699777821
Name:NADLER, DANIEL J
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:NADLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HAZEL LANE
Mailing Address - Street 2:STE 102
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1554
Mailing Address - Country:US
Mailing Address - Phone:412-741-5577
Mailing Address - Fax:412-741-1141
Practice Address - Street 1:111 HAZEL LANE
Practice Address - Street 2:STE 102
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1554
Practice Address - Country:US
Practice Address - Phone:412-741-5577
Practice Address - Fax:412-741-1141
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026919E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0867200Medicaid
PA124251Medicare PIN
PAB72993Medicare UPIN