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General NPI Number Information
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NPI Number | 1528221264
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Entity Type | Individual
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Provider Name | DANELLE ELIZABETH MAGNIFICO PTA
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Gender | Female
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 29 BEACON STREET
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City | NORWALK
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State | CT
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Zip | 06851
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Country | US
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Telephone | 203-866-3322
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Fax |
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Provider Business Mailing Address
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Address Line | 29 BEACON ST
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City | NORWALK
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State | CT
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Zip | 06851-5802
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Country | US
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Telephone | 203-866-3322
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 000247
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License Number State | CT
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