Provider Demographics
NPI:1093844599
Name:MULHOLLAND, DEBORAH A (DPT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:A
Other - Last Name:SOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:833 CHESTNUT ST
Mailing Address - Street 2:SUITE 1402
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4414
Mailing Address - Country:US
Mailing Address - Phone:800-321-9999
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:400 ENTERPRISE DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-1218
Practice Address - Country:US
Practice Address - Phone:800-321-9999
Practice Address - Fax:267-339-3763
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015680225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396648Medicare Oscar/Certification
PA396761Medicare Oscar/Certification