Provider Demographics
NPI:1568415388
Name:NEAL, DANIAL A (PT)
Entity Type:Individual
Prefix:
First Name:DANIAL
Middle Name:A
Last Name:NEAL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18444 N 25TH AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-1261
Mailing Address - Country:US
Mailing Address - Phone:623-537-5600
Mailing Address - Fax:866-939-2673
Practice Address - Street 1:18444 N 25TH AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-1261
Practice Address - Country:US
Practice Address - Phone:623-537-5600
Practice Address - Fax:866-939-2673
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5826225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5550830003OtherMEDICARE NSC PEORIA
AZ5550830009OtherMEDICARE NSC AZ NORTH
AZ5550830010OtherMEDICARE NSC GILBERT
AZ5550830001OtherMEDICARE NSC SCW
AZ5550830008OtherMEDICARE NSC SWV
AZ5550830006OtherMEDICARE NSC ANTHEM
AZ5550830007OtherMEDICARE NSC DV
AZ5550830004OtherMEDICARE NSC PV
AZ863482Medicaid
AZP20475Medicare UPIN
AZZ113300Medicare PIN