Provider Demographics
NPI:1033318597
Name:REGALA, DANILO S JR (PT)
Entity Type:Individual
Prefix:
First Name:DANILO
Middle Name:S
Last Name:REGALA
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8778 52ND AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3932
Mailing Address - Country:US
Mailing Address - Phone:917-476-3523
Mailing Address - Fax:718-358-4854
Practice Address - Street 1:5731 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5332
Practice Address - Country:US
Practice Address - Phone:718-358-7246
Practice Address - Fax:718-358-4854
Is Sole Proprietor?:No
Enumeration Date:2007-07-15
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0260772251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic