Healthcare Provider Details

I. General information

NPI: 1205658044
Provider Name (Legal Business Name): DANIEL MOLINARO PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2024
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 FRANKLIN PL
FRANKLIN SQUARE NY
11010-3923
US

IV. Provider business mailing address

221 TERRY BLVD
HOLBROOK NY
11741-3320
US

V. Phone/Fax

Practice location:
  • Phone: 516-358-8911
  • Fax:
Mailing address:
  • Phone: 631-291-5035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number010900
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: