Provider Demographics
NPI:1104525484
Name:LEONE, DANIELLA (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:DANIELLA
Middle Name:
Last Name:LEONE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 WANTAGH AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2133
Mailing Address - Country:US
Mailing Address - Phone:516-628-7700
Mailing Address - Fax:516-279-1373
Practice Address - Street 1:747 WANTAGH AVE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-2133
Practice Address - Country:US
Practice Address - Phone:516-628-7700
Practice Address - Fax:516-279-1373
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026195-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist