Provider Demographics
NPI:1699371708
Name:MAURICE, DANIELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MAURICE
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 1:425 BRIGHTON ST APT 405
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1246
Mailing Address - Country:US
Mailing Address - Phone:516-510-1077
Mailing Address - Fax:
Practice Address - Street 1:755 MEMORIAL PKWY STE 208
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2773
Practice Address - Country:US
Practice Address - Phone:908-847-6756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA019691002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic