Provider Demographics
NPI:1124625074
Name:DAMAS, DANIELLE
Entity type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:
Last Name:DAMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 E SUNRISE HWY STE 500
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1233
Mailing Address - Country:US
Mailing Address - Phone:516-355-1230
Mailing Address - Fax:949-437-8376
Practice Address - Street 1:137 NATIONAL PLZ STE 300
Practice Address - Street 2:
Practice Address - City:NATIONAL HARBOR
Practice Address - State:MD
Practice Address - Zip Code:20745-1153
Practice Address - Country:US
Practice Address - Phone:518-807-6971
Practice Address - Fax:518-213-4784
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403233363LP0808X
MDR259068363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty