Provider Demographics
NPI:1669533501
Name:PRATA, DANIEL (PT, DPT, COMT)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:PRATA
Suffix:
Gender:M
Credentials:PT, DPT, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 CLIFTON AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3633
Mailing Address - Country:US
Mailing Address - Phone:973-400-3730
Mailing Address - Fax:973-400-3731
Practice Address - Street 1:1111 CLIFTON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3633
Practice Address - Country:US
Practice Address - Phone:973-400-3730
Practice Address - Fax:973-400-3731
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01212000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist