Provider Demographics
NPI:1366687980
Name:DAUBEL, TRACY MARIE (PT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:MARIE
Last Name:DAUBEL
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:MARIE
Other - Last Name:DAUBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, ATC
Mailing Address - Street 1:25 OVERLOOK TER
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-1309
Mailing Address - Country:US
Mailing Address - Phone:845-778-5896
Mailing Address - Fax:
Practice Address - Street 1:25 OVERLOOK TER
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-1309
Practice Address - Country:US
Practice Address - Phone:845-778-5896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist