Provider Demographics
NPI:1487834537
Name:DISABATINO, DANIEL J (PT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:DISABATINO
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:1377 MOTOR PKWY STE 307
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-580-5222
Practice Address - Street 1:444 HURFFVILLE CROSSKEYS RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2372
Practice Address - Country:US
Practice Address - Phone:856-582-8000
Practice Address - Fax:856-582-8319
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2018-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA40QA00223000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ034572Medicare PIN