Provider Demographics
NPI:1053558833
Name:GAITAN, DANIEL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:GAITAN
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 1:145 W 15TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6701
Mailing Address - Country:US
Mailing Address - Phone:718-963-4430
Mailing Address - Fax:
Practice Address - Street 1:217 HAVEMEYER ST
Practice Address - Street 2:4TH. FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-6277
Practice Address - Country:US
Practice Address - Phone:718-963-4430
Practice Address - Fax:718-963-0814
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical