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General NPI Number Information
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NPI Number | 1922373364
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Entity Type | Organization
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Legal Business Name | EITAN DANIEL REHABILITATION LLC
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Dates
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Enumeration Date | 03/19/2012
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | 305 E 78TH ST APT 4FW
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City | NEW YORK
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State | NY
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Zip | 10075-1334
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Country | US
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Telephone | 347-683-1681
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Fax |
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Provider Business Mailing Address
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Address Line | 305 E 78TH ST APT 4FW
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City | NEW YORK
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State | NY
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Zip | 10075-1334
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Country | US
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Telephone | 347-683-1681
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. EITAN DANIEL
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Credential | DPT
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Telephone | 347-683-1681
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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 | 31968
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License Number State | NY
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