Provider Demographics
NPI:1891167177
Name:NUZZO, DANIEL VINCENT (DPT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:VINCENT
Last Name:NUZZO
Suffix:
Gender:M
Credentials: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 SUGARBERRY RD
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-4903
Mailing Address - Country:US
Mailing Address - Phone:609-204-4321
Mailing Address - Fax:
Practice Address - Street 1:10 SUGARBERRY ROAD
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234
Practice Address - Country:US
Practice Address - Phone:609-365-8499
Practice Address - Fax:609-345-8498
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0004071225100000X
NJ40QA01638200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist