Basic Information
Provider Information
NPI: 1932709300
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAHANAP
FirstName: DANIELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 576 BROADHOLLOW RD
Address2:  
City: MELVILLE
State: NY
PostalCode: 117475002
CountryCode: US
TelephoneNumber: 6313595859
FaxNumber:  
Practice Location
Address1: 20 COOK PLZ
Address2:  
City: MADISON
State: NJ
PostalCode: 079401951
CountryCode: US
TelephoneNumber: 9732956460
FaxNumber: 9732615810
Other Information
ProviderEnumerationDate: 10/27/2020
LastUpdateDate: 10/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QB00330900NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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