Provider Demographics
NPI:1669577441
Name:RODIA, DARREN A (DPT)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:A
Last Name:RODIA
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 1:163 POTTSTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-9518
Mailing Address - Country:US
Mailing Address - Phone:610-458-6464
Mailing Address - Fax:610-458-6465
Practice Address - Street 1:163 POTTSTOWN PIKE
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425-9518
Practice Address - Country:US
Practice Address - Phone:610-458-6464
Practice Address - Fax:610-458-6465
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017477208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA205420767OtherTAX IDENTIFICATION
PA205420767OtherTAX IDENTIFICATION