Healthcare Provider Details

I. General information

NPI: 1740229285
Provider Name (Legal Business Name): DANIELLE T OROURKE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE T PATRICK PA-C

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 WOODBINE LN
DANVILLE PA
17821-8029
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-8050
  • Fax: 570-271-5940
Mailing address:
  • Phone: 570-271-6144
  • Fax: 570-271-6578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberOA000300L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA002268L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: