Healthcare Provider Details

I. General information

NPI: 1417368572
Provider Name (Legal Business Name): DANIELLE COLAPRICO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 05/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 NEWARK POMPTON TPKE
RIVERDALE NJ
07457-1141
US

IV. Provider business mailing address

18 NEWARK POMPTON TPKE
RIVERDALE NJ
07457-1141
US

V. Phone/Fax

Practice location:
  • Phone: 973-616-8300
  • Fax: 973-616-9314
Mailing address:
  • Phone: 973-616-8300
  • Fax: 973-616-9314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number46TR00647900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: