Healthcare Provider Details

I. General information

NPI: 1518978758
Provider Name (Legal Business Name): DANIELLE J GODINEZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W MAIN ST
SAXONBURG PA
16056-2255
US

IV. Provider business mailing address

333 W MAIN ST
SAXONBURG PA
16056-2255
US

V. Phone/Fax

Practice location:
  • Phone: 724-352-8422
  • Fax: 724-352-8426
Mailing address:
  • Phone: 724-352-8422
  • Fax: 724-352-8426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS012208
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: