Individual
DANA STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
6 LOCUST ST, GREENE, NY 13778-1018
(607) 753-1886
Mailing address
6 LOCUST ST, GREENE, NY 13778-1018
(607) 753-1886
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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