Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | RT005112 | PA |
Y | 213ES0000X | Sports Medicine | RT005112 | PA |
NPI | 1457692865 |
---|---|
Provider Name | Daniel David Picarella |
First Address | Hollidaysburg, PA 16648-1568 |
Second Address | Hollidaysburg, PA 16648-1568 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2013 |
Last Update Date | 11/03/2013 |