Provider Demographics
NPI:1518584481
Name:KREDA, DANIELLE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:KREDA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 INFIELD LN
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-1703
Mailing Address - Country:US
Mailing Address - Phone:732-939-1285
Mailing Address - Fax:
Practice Address - Street 1:10 INFIELD LN
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-1703
Practice Address - Country:US
Practice Address - Phone:732-939-1285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01872800--225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist