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NPI 1609828532

NPI 1609828532 : DANIELLE MARIE GRAZIANI-LUDWIG P.A. : PHILADELPHIA, PA

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General NPI Number Information
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    NPI Number           |    1609828532
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    Entity Type          |    Individual 
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    Provider Name        |    DANIELLE MARIE GRAZIANI-LUDWIG P.A.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/17/2006
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    Last Update Date     |    10/03/2019
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Provider Practice Location Address
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    Address Line         |    10159 VERREE RD 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19116-3613
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    Country              |    US
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    Telephone            |    215-677-1155
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    Fax                  |    215-677-5424
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Provider Business Mailing Address
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    Address Line         |    151 SOUTHHALL LN STE 300 
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    City                 |    MAITLAND
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    State                |    FL
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    Zip                  |    32751-7172
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    Country              |    US
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    Telephone            |    407-875-2080
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    Fax                  |    407-650-3455
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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        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    MA051994
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    License Number State |    PA
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