Provider Demographics
NPI:1538786777
Name:FAISON, DANAE
Entity type:Individual
Prefix:
First Name:DANAE
Middle Name:
Last Name:FAISON
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 1:1305 W CHESTER PIKE STE 18
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2929
Mailing Address - Country:US
Mailing Address - Phone:267-618-0208
Mailing Address - Fax:
Practice Address - Street 1:183 W CITY AVE STE 2
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3102
Practice Address - Country:US
Practice Address - Phone:267-618-0208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-04
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health