Provider Demographics
NPI:1972788065
Name:DANIELS, AARON (PA-C)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:DANIELS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 CRANBURY RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4092
Mailing Address - Country:US
Mailing Address - Phone:732-390-1160
Mailing Address - Fax:732-390-8449
Practice Address - Street 1:585 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4092
Practice Address - Country:US
Practice Address - Phone:732-390-1160
Practice Address - Fax:732-390-8449
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00191200363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ245040Medicare PIN
NJ120632M5NMedicare PIN