Provider Demographics
NPI:1114091493
Name:BOWDEN, DANIELLE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BOWDEN
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 1:31 CULVER STREET
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2409
Mailing Address - Country:US
Mailing Address - Phone:908-231-8896
Mailing Address - Fax:
Practice Address - Street 1:903 US HIGHWAY 202
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1419
Practice Address - Country:US
Practice Address - Phone:908-725-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA00769800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist