Individual
DANIEL MARDKHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
7 NEW YORK AVE # 25A, SMITHTOWN, NY 11787-3447
(631) 724-2200
Mailing address
30 TRESCOTT PATH, NORTHPORT, NY 11768-2538
(516) 306-1994
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
116002-01
NY
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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