Provider Demographics
NPI:1235712639
Name:DIPERNA, DANIEL (DPT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:DIPERNA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3322 BROOKVIEW PL
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2808
Mailing Address - Country:US
Mailing Address - Phone:850-377-2799
Mailing Address - Fax:
Practice Address - Street 1:1340 WONDER WORLD DR STE 2100
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7694
Practice Address - Country:US
Practice Address - Phone:512-753-3539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist