Provider Demographics
NPI:1326038282
Name:LOVE, DEBORAH (PT)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:LOVE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 W MONTAUK HWY
Mailing Address - Street 2:SUITE E4
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-2363
Mailing Address - Country:US
Mailing Address - Phone:631-728-6377
Mailing Address - Fax:631-728-6922
Practice Address - Street 1:188 W MONTAUK HWY
Practice Address - Street 2:SUITE E4
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-2363
Practice Address - Country:US
Practice Address - Phone:631-728-6377
Practice Address - Fax:631-728-6922
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0034741225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist