Provider Demographics
NPI:1013029636
Name:SIGNORINO, DEBORAH MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:MARIE
Last Name:SIGNORINO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14 S BRYN MAWR AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3216
Mailing Address - Country:US
Mailing Address - Phone:610-525-0935
Mailing Address - Fax:610-525-7170
Practice Address - Street 1:14 S BRYN MAWR AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3216
Practice Address - Country:US
Practice Address - Phone:610-525-0935
Practice Address - Fax:610-525-7170
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE0068T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30406Medicare UPIN