1508166646

Everything you always wanted to know about KELLEHER A. DANIEL NP but were afraid to ask.

KELLEHER A. DANIEL NP

You can also download the this 1508166646 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name Provider Credential
KELLEHER A. DANIEL NP
Gender:
Male
Enumeration date:
2010-10-22
Last update date:
2017-10-04
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
Search for DANIEL, KELLEHER in
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Identifiers

identifier description issuer state
S400348821 Medicare PIN none MA
002353302 Medicare PIN none MA
S400261388 Medicare PIN none MA
002353303 Medicare PIN none MA
002353301 Medicare PIN none MA
002353304 Medicare PIN none MA
S400261388 Medicare OSCAR/Certification none MA
110097151A Medicaid none MA

Taxonomies

Taxonomy State License Number Primary?
363LA2100X Acute Care MA RN267406 N
363L00000X Nurse Practitioner MA RN267406 Y

Phone Numbers

Type Number
Practice Location Address Telephone Number 5084211400
Practice Location Address Fax Number 5084211490

Addresses

Type Address City State Postal Country
Mailing Address 22 BAKER ST DEPARTMENT OF EMERGENCY MEDICINE FOXBORO MA 2035 MA
Practice Location Address 157 UNION ST MARLBOROUGH MA 0 MA

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