Provider Demographics
NPI:1902598741
Name:MCDWYER, DANIEL JACOB (LDO)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JACOB
Last Name:MCDWYER
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:56 W MERRITT BLVD
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2243
Mailing Address - Country:US
Mailing Address - Phone:845-896-8741
Mailing Address - Fax:845-896-8783
Practice Address - Street 1:56 W MERRITT BLVD
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2243
Practice Address - Country:US
Practice Address - Phone:845-896-8741
Practice Address - Fax:845-896-8783
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009540156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician