Healthcare Provider Details

I. General information

NPI: 1619905569
Provider Name (Legal Business Name): GARY DANNI P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 04/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CETRONIA ROAD
ALLENTOWN PA
18104
US

IV. Provider business mailing address

250 CETRONIA RD
ALLENTOWN PA
18104-9147
US

V. Phone/Fax

Practice location:
  • Phone: 610-360-0136
  • Fax:
Mailing address:
  • Phone: 610-973-6200
  • Fax: 866-644-0894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License NumberPT000349E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: