Provider Demographics
NPI:1417996760
Name:STARKEY, COLLEEN NICOLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:NICOLE
Last Name:STARKEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:NICOLE
Other - Last Name:OCONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MARCUS HOOK
Mailing Address - State:PA
Mailing Address - Zip Code:19061-4513
Mailing Address - Country:US
Mailing Address - Phone:610-859-8850
Mailing Address - Fax:610-672-9936
Practice Address - Street 1:744 CHRISTIANA ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4236
Practice Address - Country:US
Practice Address - Phone:302-368-4841
Practice Address - Fax:302-368-4843
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002016225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000108723OtherDPCI
DEP00292590OtherRAILROAD MEDICARE
DE1417996760Medicaid
214667OtherUNISON
3744468000OtherPERSONAL CHOICE
PA2123150OtherPA BS
Q64107Medicare UPIN
214667OtherUNISON