Provider Demographics
NPI:1942446182
Name:MCBRIDE, DANIEL KEVIN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:KEVIN
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:MR
Other - First Name:DANIEL
Other - Middle Name:KEVIN
Other - Last Name:MCBRIDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:707 BEACH AVE REAR 4
Mailing Address - Street 2:707 BEACH AVE APT 4
Mailing Address - City:BRADLEY BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07720-1905
Mailing Address - Country:US
Mailing Address - Phone:917-337-4831
Mailing Address - Fax:732-942-9554
Practice Address - Street 1:150 AIRPORT RD STE 100
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-6925
Practice Address - Country:US
Practice Address - Phone:732-942-9550
Practice Address - Fax:732-942-9554
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00838500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist