Provider Demographics
NPI:1235118472
Name:SUNDIE, DANIEL F (PT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:F
Last Name:SUNDIE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 MOUNTAIN LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16002-3970
Mailing Address - Country:US
Mailing Address - Phone:724-586-2350
Mailing Address - Fax:724-282-6624
Practice Address - Street 1:116 WOODY DR
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5692
Practice Address - Country:US
Practice Address - Phone:724-283-7177
Practice Address - Fax:724-283-5377
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA067940HBGMedicare ID - Type Unspecified