Provider Demographics
NPI:1689977381
Name:DEPRATTI, DEBORAH J
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:DEPRATTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BRICKSTONE SQ
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1437
Mailing Address - Country:US
Mailing Address - Phone:978-247-5169
Mailing Address - Fax:484-813-6108
Practice Address - Street 1:32 HOSPITAL HILL RD
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-2302
Practice Address - Country:US
Practice Address - Phone:978-632-5477
Practice Address - Fax:978-632-4869
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-19
Last Update Date:2010-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA136225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant