Provider Demographics
NPI:1861869257
Name:DANIEL SZOCIK
Entity type:Organization
Organization Name:DANIEL SZOCIK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.N.A
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SZOCIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-500-2422
Mailing Address - Street 1:49 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04254-1425
Mailing Address - Country:US
Mailing Address - Phone:207-500-2422
Mailing Address - Fax:
Practice Address - Street 1:49 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LIVERMORE FALLS
Practice Address - State:ME
Practice Address - Zip Code:04254-1425
Practice Address - Country:US
Practice Address - Phone:207-500-2422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME32320700000X
ME34229503A320700000X
MENAT67103320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME34229503AOtherMAINE CARE
ME=========AOtherMEDICARE