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General NPI Number Information
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NPI Number | 1578997102
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Entity Type | Individual
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Provider Name | DANIELLE MARGARET ANNIS ATC
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Gender | Female
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Dates
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Enumeration Date | 08/30/2013
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Last Update Date | 08/30/2013
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Provider Practice Location Address
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Address Line | 3959 BROADWAY 8TH FLOOR, NORTH
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City | NEW YORK
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State | NY
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Zip | 10032-1559
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Country | US
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Telephone | 212-305-4565
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Fax |
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Provider Business Mailing Address
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Address Line | 631 N TERRACE AVE APT 5H
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City | MOUNT VERNON
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State | NY
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Zip | 10552-2756
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Country | US
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Telephone | 914-621-6219
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 001586
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License Number State | NY
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