Provider Demographics
NPI:1447332507
Name:PACE, DANIEL ANTHONY (PHD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ANTHONY
Last Name:PACE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 7TH ST
Mailing Address - Street 2:SUITE #111
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5731
Mailing Address - Country:US
Mailing Address - Phone:516-279-7305
Mailing Address - Fax:
Practice Address - Street 1:500 OLD COUNTRY RD
Practice Address - Street 2:SUITE #301 B
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1901
Practice Address - Country:US
Practice Address - Phone:516-279-7305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017585103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300052553OtherPTAN