Provider Demographics
NPI:1194733683
Name:ABRUZZI, DANIEL E (DPT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:ABRUZZI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WEBSTER ST
Mailing Address - Street 2:SUITE 331
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2373
Mailing Address - Country:US
Mailing Address - Phone:415-600-7892
Mailing Address - Fax:415-923-5896
Practice Address - Street 1:948 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2010
Practice Address - Country:US
Practice Address - Phone:510-526-2353
Practice Address - Fax:510-526-2022
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT320812251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGJ524ZMedicare PIN
CAZZZ06873ZMedicare PIN
CAGJ524YMedicare PIN
CAW17215CMedicare PIN
CAPT32081Medicare UPIN