Provider Demographics
NPI:1437654431
Name:DAUCHER, ANNAMARIA (DPT)
Entity Type:Individual
Prefix:
First Name:ANNAMARIA
Middle Name:
Last Name:DAUCHER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 CHARLANE PKWY
Mailing Address - Street 2:
Mailing Address - City:N SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4211
Mailing Address - Country:US
Mailing Address - Phone:315-546-3897
Mailing Address - Fax:
Practice Address - Street 1:41555 COOK ST STE 100
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211
Practice Address - Country:US
Practice Address - Phone:760-837-0033
Practice Address - Fax:760-837-1013
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042220225100000X
GAPT013210225100000X
CAPT294833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist