Healthcare Provider Details

I. General information

NPI: 1164488375
Provider Name (Legal Business Name): DANIELLE T CANNELLA MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE L TROMBETTA SEIDER MPT

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 NAT TURNER BLVD S
NEWPORT NEWS VA
23606-3074
US

IV. Provider business mailing address

901 ENTERPRISE PKWY SUITE 900
HAMPTON VA
23666-6249
US

V. Phone/Fax

Practice location:
  • Phone: 757-596-1900
  • Fax: 757-591-8560
Mailing address:
  • Phone: 757-827-2481
  • Fax: 757-827-2566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305202228
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: