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Individual
DANA STALEY
Active
Individual
DANA STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
021565
PA
225100000X
Physical Therapist
Primary
030615
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021565
PENNSYLVANIA DEPARTMENT OF EDUCATION
PA
01
—
030615
NY STATE DEPARTMENT OF EDUCATION
NY
Enumeration date
10/11/2012
Last updated
10/11/2012
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