Provider Demographics
NPI:1982776365
Name:CARDONA, DANIELLE MARIE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MARIE
Last Name:CARDONA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 RIVER RD
Mailing Address - Street 2:UNIT C
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3618
Mailing Address - Country:US
Mailing Address - Phone:973-320-2406
Mailing Address - Fax:
Practice Address - Street 1:448 RIVER RD
Practice Address - Street 2:UNIT C
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3618
Practice Address - Country:US
Practice Address - Phone:973-320-2406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00981200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist