Provider Demographics
NPI:1801953997
Name:SOCCI, DANA (MSPT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SOCCI
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:6 CHARLES CT
Mailing Address - Street 2:P.O. BOX 416
Mailing Address - City:RINGOES
Mailing Address - State:NJ
Mailing Address - Zip Code:08551-2032
Mailing Address - Country:US
Mailing Address - Phone:908-884-6959
Mailing Address - Fax:
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-8661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01925225100000X
NJ40QA00990500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist