Provider Demographics
NPI:1609045228
Name:ENDY, DEANNE STARR (DO)
Entity Type:Individual
Prefix:
First Name:DEANNE
Middle Name:STARR
Last Name:ENDY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:DEANNE
Other - Middle Name:
Other - Last Name:STARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:225 N FRONT ST
Practice Address - Street 2:
Practice Address - City:STEELTON
Practice Address - State:PA
Practice Address - Zip Code:17113-2240
Practice Address - Country:US
Practice Address - Phone:717-939-4593
Practice Address - Fax:717-939-0955
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006156L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028821280002Medicaid
PA2S2968OtherMEDICARE