Basic Information
Provider Information
NPI: 1093844599
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MULHOLLAND
FirstName: DEBORAH
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SOCK
OtherFirstName: DEBORAH
OtherMiddleName: A
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: DPT
OtherLastNameType: 1
Mailing Information
Address1: 833 CHESTNUT ST
Address2: SUITE 1402
City: PHILADELPHIA
State: PA
PostalCode: 191074414
CountryCode: US
TelephoneNumber: 8003219999
FaxNumber: 2673393761
Practice Location
Address1: 400 ENTERPRISE DR
Address2: 3RD FLOOR
City: LIMERICK
State: PA
PostalCode: 194681218
CountryCode: US
TelephoneNumber: 8003219999
FaxNumber: 2673393763
Other Information
ProviderEnumerationDate: 03/02/2007
LastUpdateDate: 01/04/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT015680PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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