Provider Demographics
NPI:1497047443
Name:BURBANO, DANNY (LAC, PTA)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:BURBANO
Suffix:
Gender:M
Credentials:LAC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-1526
Mailing Address - Country:US
Mailing Address - Phone:973-857-1616
Mailing Address - Fax:
Practice Address - Street 1:72 MAIN ST
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1526
Practice Address - Country:US
Practice Address - Phone:973-857-1616
Practice Address - Fax:973-500-6806
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00254400225200000X
NJ25MZ00151400171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant