Provider Demographics
NPI:1366113623
Name:MEAD, DANIELA C (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:C
Last Name:MEAD
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 1:139 CROSBY STREET EXT
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-2207
Mailing Address - Country:US
Mailing Address - Phone:267-240-2046
Mailing Address - Fax:
Practice Address - Street 1:139 CROSBY STREET EXT
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-2207
Practice Address - Country:US
Practice Address - Phone:267-240-2046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-25
Last Update Date:2024-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024755225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist