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General NPI Number Information
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NPI Number | 1184951501
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Entity Type | Organization
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Legal Business Name | FUNCTIONAL PERFORMANCE INSTITUTE PC
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Dates
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Enumeration Date | 11/05/2009
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Last Update Date | 11/06/2019
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Provider Practice Location Address
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Address Line | 2 CHANGEBRIDGE RD UNIT F
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City | MONTVILLE
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State | NJ
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Zip | 07045-8947
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Country | US
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Telephone | 908-432-4334
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Fax | 908-469-2638
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Provider Business Mailing Address
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Address Line | 313 SOUTH AVE STE 205
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City | FANWOOD
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State | NJ
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Zip | 07023-1364
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Country | US
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Telephone | 908-288-7049
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Fax | 908-288-7225
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIELLE JEAN DAMELIO
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Credential | DC
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Telephone | 908-432-4334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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