Provider Demographics
NPI:1942415880
Name:DUKER, DANIEL GREGORY JR (MPT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:GREGORY
Last Name:DUKER
Suffix:JR
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 NEELY SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7536
Mailing Address - Country:US
Mailing Address - Phone:724-816-3583
Mailing Address - Fax:724-821-9555
Practice Address - Street 1:119 NEELY SCHOOL RD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7536
Practice Address - Country:US
Practice Address - Phone:724-816-3583
Practice Address - Fax:724-821-9555
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009173L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADU1511156OtherHIGHMARK PREMIERBLUE