| Dr Daniel Marc Gagnon, DPT | |
| 77 Route 112 Ste F, Patchogue, NY 11772-1230 | |
| (631) 207-2370 | |
| Not Available | 
| Full Name | Dr Daniel Marc Gagnon | 
|---|---|
| Gender | Male | 
| Speciality | Physical Therapist | 
| Location | 77 Route 112 Ste F, Patchogue, New York | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1285386441 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 225100000X | Physical Therapist | 04749301 (New York) | Primary | 
| Provider Name | Sports Physical Therapy Occupational Therapy And Rehabilitation Servic | 
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice | 
| Provider Identifiers | NPI Number: 1770540593 PECOS PAC ID: 0446140446 Enrollment ID: O20040315001603 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Daniel Marc Gagnon, DPT 90 Maddox Ave, Islip, NY 11751-2906 Ph: (631) 335-8309 | Dr Daniel Marc Gagnon, DPT 77 Route 112 Ste F, Patchogue, NY 11772-1230 Ph: (631) 207-2370 | 
| Ronald Amaya Lopez, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 322 W Main St, Patchogue, NY 11772 Phone: 631-228-4977 | |
| Sungguk Bae,  Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 21 Cleveland St, Patchogue, NY 11772 Phone: 631-569-9373 | |
| Nicole Marie Divirgilio, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 77 Route 112 Ste F, Patchogue, NY 11772 Phone: 631-207-2370 | |
| John Lowe Wilson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 25 Theresa Ct, Patchogue, NY 11772 Phone: 631-730-3326 | |
| Danielle M Bousquet,  Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 77 Medford Ave, Patchogue, NY 11772 Phone: 631-758-1910 | |
| Stephanie Lauren Vanschaick, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 77 Medford Ave, Patchogue, NY 11772 Phone: 631-758-1910 Fax: 631-758-1984 | |
| Kathleen Alyssa Bailey, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 322 W Main St, Patchogue, NY 11772 Phone: 631-228-4977 |