Provider Demographics
NPI:1053950584
Name:BLINDER, DANIEL (PT DPT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BLINDER
Suffix:
Gender:M
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329B OLYMPIA BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-4233
Mailing Address - Country:US
Mailing Address - Phone:917-365-3463
Mailing Address - Fax:
Practice Address - Street 1:1500 BLONDELL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2643
Practice Address - Country:US
Practice Address - Phone:917-365-3463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-01
Last Update Date:2020-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist