Basic Information
Provider Information
NPI: 1922600659
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAAD
FirstName: DANIELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 307 5TH AVE FL 6
Address2:  
City: NEW YORK
State: NY
PostalCode: 100166575
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 794 UNION ST FL 3
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112157724
CountryCode: US
TelephoneNumber: 6468411402
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/09/2020
LastUpdateDate: 11/09/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/09/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X046199NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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