MEDICARE: JOSEPH DAIGNEAU

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	PT028816	PA

General Provider Information

NPI Number	:	1891393914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH DAIGNEAU

Provider Business Mailing Address
First Line	:	379 HELENE PL
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19116-2740
Country	:	US
Telephone Number	:	215-960-1331
Fax Number	:

Provider Business Practice Location Address
First Line	:	379 HELENE PL
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19116-2740
Country	:	US
Telephone Number	:	215-960-1331
Fax Number	:

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

Provider Enumeration Date	:	10/12/2020
Last Update Date	:	10/14/2020

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