Provider Demographics
NPI:1003882580
Name:DONNELLY, ERIN M (PHYSICAL THERAPY ASS)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:M
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:PHYSICAL THERAPY ASS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E MAPLE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2186
Mailing Address - Country:US
Mailing Address - Phone:267-982-3623
Mailing Address - Fax:
Practice Address - Street 1:133 E MAPLE AVE FL 2
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-2186
Practice Address - Country:US
Practice Address - Phone:267-982-3623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0034872255A2300X
PATE012511225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty