Provider Demographics
NPI:1780027706
Name:PORBUNDERWALA, DANIELLE ALEXANDRA (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ALEXANDRA
Last Name:PORBUNDERWALA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:ALEXANDRA
Other - Last Name:MORRONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1750 ELM ST STE 201A
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2903
Mailing Address - Country:US
Mailing Address - Phone:603-668-6489
Mailing Address - Fax:603-663-7884
Practice Address - Street 1:1750 ELM ST STE 201A
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2903
Practice Address - Country:US
Practice Address - Phone:603-668-6489
Practice Address - Fax:603-663-7884
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH17527207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine