Danielle M Duffy, LAT ATC

Individual provider Active NPI Athletic Trainer · Glenside, PA

NPI 1164077574 · NPPES record last updated Aug 3, 2019

Key facts

NPI
1164077574
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT005993 (PA)
Practice address
450 S Easton Rd
Glenside, PA 19038-3215
Phone
(215) 572-2848
NPI assigned
Aug 3, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RT005993PAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT005993 PA Yes

Addresses

Primary practice location

450 S Easton Rd
Glenside, PA 19038-3215

Mailing address

450 S Easton Rd
Glenside, PA 19038-3215
Phone (215) 572-2848

Other providers in Glenside, PA

All providers in Glenside, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.