Provider Demographics
NPI:1376647461
Name:MCGINLEY, COLLEEN THERESA (DPT)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:THERESA
Last Name:MCGINLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:THERESA
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:3600 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2630
Mailing Address - Country:US
Mailing Address - Phone:215-677-0400
Mailing Address - Fax:215-677-5181
Practice Address - Street 1:3600 GRANT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2630
Practice Address - Country:US
Practice Address - Phone:215-677-0400
Practice Address - Fax:215-671-1837
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2122587000OtherPERSONAL CHOICE
PA2719098000OtherBLUE CROSS
PA0007484435OtherAETNA
PA1860368OtherBLUE SHIELD
PA2122587000OtherPERSONAL CHOICE