Provider Demographics
NPI:1497122923
Name:HOOSE, DANIELLE LYNN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:LYNN
Last Name:HOOSE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:LYNN
Other - Last Name:MARINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:8256 DEXTER PKWY
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-1007
Mailing Address - Country:US
Mailing Address - Phone:315-481-6013
Mailing Address - Fax:
Practice Address - Street 1:159 W 1ST ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2045
Practice Address - Country:US
Practice Address - Phone:315-342-9575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251P0200X
NY0395082251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics