Provider Demographics
NPI:1346604121
Name:MACKLIN, DANIT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANIT
Middle Name:
Last Name:MACKLIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 SAGAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2626
Mailing Address - Country:US
Mailing Address - Phone:201-575-6291
Mailing Address - Fax:201-490-5902
Practice Address - Street 1:1086 TEANECK RD STE 3E
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4855
Practice Address - Country:US
Practice Address - Phone:551-888-2282
Practice Address - Fax:201-490-5902
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00927000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist