Provider Demographics
NPI:1295572980
Name:MINIERI, DANIELLE LYNN
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LYNN
Last Name:MINIERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 HYMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-6109
Mailing Address - Country:US
Mailing Address - Phone:631-383-5533
Mailing Address - Fax:
Practice Address - Street 1:14 TYLER ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3224
Practice Address - Country:US
Practice Address - Phone:617-629-3919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist