Provider Demographics
NPI:1164488375
Name:CANNELLA, DANIELLE T (MPT)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:T
Last Name:CANNELLA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MRS
Other - First Name:DANIELLE
Other - Middle Name:L
Other - Last Name:TROMBETTA SEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:901 ENTERPRISE PKWY
Mailing Address - Street 2:SUITE 900
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6249
Mailing Address - Country:US
Mailing Address - Phone:757-827-2481
Mailing Address - Fax:757-827-2566
Practice Address - Street 1:901 ENTERPRISE PKWY
Practice Address - Street 2:SUITE 900
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6249
Practice Address - Country:US
Practice Address - Phone:757-827-2481
Practice Address - Fax:757-827-2566
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202228225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010189179Medicaid
7839617OtherAETNA
VAP00201729OtherRAILROAD MEDICARE
VA192931OtherBCBS PHYSICAL THERAPY
VA010189179Medicaid
VAP00201729OtherRAILROAD MEDICARE