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General NPI Number Information
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NPI Number | 1730895509
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Entity Type | Individual
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Provider Name | DANIELLE MARIE BONGIORNO
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Gender | Female
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Dates
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Enumeration Date | 01/25/2023
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 3297 FIVE POINTS DR
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City | AUBURN HILLS
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State | MI
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Zip | 48326-2337
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Country | US
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Telephone | 248-353-1234
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Fax | 586-275-0735
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Provider Business Mailing Address
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Address Line | 1824 HICKORY BARK LN
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48304-1116
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Country | US
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Telephone | 586-929-0580
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501302292
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 5501302292
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License Number State | MI
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