Provider Demographics
NPI:1497815146
Name:SZAFRAN, DEBORA MARIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:MARIA
Last Name:SZAFRAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1647 FORT WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLE GLEN
Mailing Address - State:PA
Mailing Address - Zip Code:19002-3046
Mailing Address - Country:US
Mailing Address - Phone:215-654-7797
Mailing Address - Fax:
Practice Address - Street 1:531 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1325
Practice Address - Country:US
Practice Address - Phone:610-828-0400
Practice Address - Fax:610-828-3869
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA050939363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA116311FCNOtherMEDICARE LEGACY NUMBER
PA116311FCNMedicare PIN
PA063188Medicare UPIN