MEDICARE: DANIELLE NATOLI

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	363A00000X	Physician Assistant	028055	NY
2	363AM0700X	Medical Physician Assistant		NY
3	363A00000X	Physician Assistant		NY

General Provider Information

NPI Number	:	1942968805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE NATOLI

Provider Business Mailing Address
First Line	:	546 BEACH 128TH ST
Second Line	:
City	:	BELLE HARBOR
State	:	NY
Zip	:	11694-1511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	546 BEACH 128TH ST
Second Line	:
City	:	ROCKAWAY PARK
State	:	NY
Zip	:	11694-1511
Country	:	US
Telephone Number	:	718-915-8177
Fax Number	:

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

Provider Enumeration Date	:	12/07/2021
Last Update Date	:	03/02/2023

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Directions to “ DANIELLE NATOLI ” Practice Location

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