Provider Demographics
NPI:1912220302
Name:LITWIN, DANIEL SACKS (DACM, LMT)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SACKS
Last Name:LITWIN
Suffix:
Gender:M
Credentials:DACM, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10020 39TH WAY N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-4044
Mailing Address - Country:US
Mailing Address - Phone:631-560-1453
Mailing Address - Fax:
Practice Address - Street 1:2 BERARD BLVD
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769
Practice Address - Country:US
Practice Address - Phone:631-589-4183
Practice Address - Fax:631-589-3619
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022926225700000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist