Provider Demographics
NPI:1669605606
Name:SIMMONS, DANIELLE ELIZABETH (DPT)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 NORTH BROADWAY
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753
Mailing Address - Country:US
Mailing Address - Phone:516-679-1207
Mailing Address - Fax:516-679-2684
Practice Address - Street 1:3728 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793
Practice Address - Country:US
Practice Address - Phone:516-827-9446
Practice Address - Fax:516-827-0042
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist