Provider Demographics
NPI:1447063185
Name:PARKER, DANIELLE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:PARKER
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 1:2160 LOCKPORT OLCOTT RD
Mailing Address - Street 2:
Mailing Address - City:BURT
Mailing Address - State:NY
Mailing Address - Zip Code:14028-9788
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6101 ROBINSON RD
Practice Address - Street 2:SOUTH SUITE
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-8920
Practice Address - Country:US
Practice Address - Phone:716-251-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004215-01225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant