Provider Demographics
NPI:1861069528
Name:ESCUDERO, DANIELA
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:ESCUDERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 99TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-1317
Mailing Address - Country:US
Mailing Address - Phone:347-848-2361
Mailing Address - Fax:
Practice Address - Street 1:232 E MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2980
Practice Address - Country:US
Practice Address - Phone:631-533-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist