Provider Demographics
NPI:1043764749
Name:PILLOT, DANIELLE MARIA (COTA/L)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIA
Last Name:PILLOT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5756
Mailing Address - Country:US
Mailing Address - Phone:978-333-0707
Mailing Address - Fax:
Practice Address - Street 1:71 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5756
Practice Address - Country:US
Practice Address - Phone:978-333-0707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008526-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor