Provider Demographics
NPI:1306960265
Name:GASIEWSKI, DANIEL JOSEPH (OTR)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:GASIEWSKI
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:CROYDON
Mailing Address - State:PA
Mailing Address - Zip Code:19021-6178
Mailing Address - Country:US
Mailing Address - Phone:215-785-6628
Mailing Address - Fax:
Practice Address - Street 1:262 TOLLGATE RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1377
Practice Address - Country:US
Practice Address - Phone:267-757-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005750L225X00000X
NJ46TR00060200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist