Basic Information
Provider Information
NPI: 1629474200
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEAN
FirstName: ERIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 106 MILFORD ST STE 601
Address2:  
City: SALISBURY
State: MD
PostalCode: 218046938
CountryCode: US
TelephoneNumber: 4105487600
FaxNumber: 4105482651
Practice Location
Address1: 15 FALLON AVE
Address2:  
City: SEAFORD
State: DE
PostalCode: 199731577
CountryCode: US
TelephoneNumber: 3025361774
FaxNumber: 3025367096
Other Information
ProviderEnumerationDate: 11/10/2014
LastUpdateDate: 11/10/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XJ1-0003235DEY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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