Provider Demographics
NPI:1568691954
Name:MEHLENBACHER, DANIELLE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:MARIE
Last Name:MEHLENBACHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2060 N PEARL ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-1926
Mailing Address - Country:US
Mailing Address - Phone:814-877-7711
Mailing Address - Fax:814-877-7715
Practice Address - Street 1:2060 N PEARL ST
Practice Address - Street 2:SUITE H
Practice Address - City:NORTH EAST
Practice Address - State:PA
Practice Address - Zip Code:16428-1926
Practice Address - Country:US
Practice Address - Phone:814-877-7711
Practice Address - Fax:814-877-7715
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34010489207Q00000X
PAOS015887207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine