Provider Demographics
NPI:1972059962
Name:LOPEZ, DANIELLE (PT)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:SHELLHAMMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:17 BETTY LN
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-1808
Mailing Address - Country:US
Mailing Address - Phone:973-907-4390
Mailing Address - Fax:
Practice Address - Street 1:309 FRIES MILL RD STE 17
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9209
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:877-407-4329
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01690500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist