Provider Demographics
NPI:1629029301
Name:PENUEL, DEAN EARL
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:EARL
Last Name:PENUEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 W OREGON AVE
Mailing Address - Street 2:3RD FLOOR SUITE
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4131
Mailing Address - Country:US
Mailing Address - Phone:215-336-6630
Mailing Address - Fax:215-336-3928
Practice Address - Street 1:2129 W OREGON AVE
Practice Address - Street 2:3RD FLOOR SUITE
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19145-4131
Practice Address - Country:US
Practice Address - Phone:215-336-6630
Practice Address - Fax:215-336-3928
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT 007946L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist