MEDICARE: DANIELLE KRISTEN EWASHKO DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	40QA01311500	NJ
2	225100000X	Physical Therapist	PT024389	PA

General Provider Information

NPI Number	:	1578797932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE KRISTEN EWASHKO DPT

Provider Business Mailing Address
First Line	:	1000 WHITE HORSE RD STE 608
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-4412
Country	:	US
Telephone Number	:	856-435-6332
Fax Number	:	856-435-6174

Provider Business Practice Location Address
First Line	:	1000 WHITE HORSE RD STE 608
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-4412
Country	:	US
Telephone Number	:	856-435-6332
Fax Number	:	856-435-6174

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	06/17/2025

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