Provider Demographics
NPI:1053491621
Name:GALVIN, DEBORAH CHERNIN (MSPT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:CHERNIN
Last Name:GALVIN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 E 86TH ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-4394
Mailing Address - Country:US
Mailing Address - Phone:317-257-1556
Mailing Address - Fax:317-257-1554
Practice Address - Street 1:5936 N KEYSTONE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2458
Practice Address - Country:US
Practice Address - Phone:317-257-8340
Practice Address - Fax:317-257-8361
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000175277OtherATHEM PIN NUMBER
IN000000175277OtherATHEM PIN NUMBER