MEDICARE: MR. ARTHUR MARTIN DANIELS PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	013186-1	NY

General Provider Information

NPI Number	:	1174641914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARTHUR MARTIN DANIELS PT

Provider Business Mailing Address
First Line	:	813 SOUTHERN BLVD
Second Line	:	PHYS THER OF THE BRONX
City	:	BRONX
State	:	NY
Zip	:	10459-5202
Country	:	US
Telephone Number	:	718-861-6787
Fax Number	:	718-861-6056

Provider Business Practice Location Address
First Line	:	813 SOUTHERN BLVD
Second Line	:	PHYS THER OF THE BRONX
City	:	BRONX
State	:	NY
Zip	:	10459-5202
Country	:	US
Telephone Number	:	718-861-6787
Fax Number	:	718-861-6056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	07/08/2007

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