Provider Demographics
NPI:1730774647
Name:FELKO, DANIEL R (CPHT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:R
Last Name:FELKO
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2103
Mailing Address - Country:US
Mailing Address - Phone:607-733-2399
Mailing Address - Fax:607-733-3006
Practice Address - Street 1:401 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2103
Practice Address - Country:US
Practice Address - Phone:607-733-2399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY44019108554954183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician