Provider Demographics
NPI:1467613257
Name:DUDDY, DANIELLE MARIE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MARIE
Last Name:DUDDY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:BENFATTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:208 WASHINGTON ST
Mailing Address - Street 2:APT. 4B
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4559
Mailing Address - Country:US
Mailing Address - Phone:609-903-0074
Mailing Address - Fax:
Practice Address - Street 1:200 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1942
Practice Address - Country:US
Practice Address - Phone:732-258-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014570225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist