| Doctor Name: | DR. GLENN R. DADDARIO |
| NPI Number: | 1619182342 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSPT, DPT |
| License Number: | 16559 |
| Business Practice Address: | 607 North Ave Door 16, 1st Floor Wakefield, MA - 018801322 |
| Business Phone Number: | 7815870776 |
| Business Fax Number: | 7815870794 |
| Mailing Address: | 10 Bayberry Rd, DANVERS |
| State: | MA |
| Postal Code: | 019231536 |
| Phone Number: | 7813674933 |
| Fax Number: | |
| NPI Enumeration Date: | 05/14/2007 |
| NPI Last Update Date: | 06/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 16559 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |