Provider Demographics
NPI:1346951787
Name:CHILLIANIS, DANIEL JAMES (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:CHILLIANIS
Suffix:
Gender:M
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 1:25 ROBINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-2717
Mailing Address - Country:US
Mailing Address - Phone:516-998-6328
Mailing Address - Fax:
Practice Address - Street 1:25 ROBINWOOD DR
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-2717
Practice Address - Country:US
Practice Address - Phone:516-998-6328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07552918Medicaid