Provider Demographics
NPI:1689987901
Name:RUTLEDGE, DEBRA ALEINE (PT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ALEINE
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 S MANNING BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1708
Mailing Address - Country:US
Mailing Address - Phone:518-437-5717
Mailing Address - Fax:518-437-5579
Practice Address - Street 1:1 BARNEY RD STE 120
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-5823
Practice Address - Country:US
Practice Address - Phone:518-373-0735
Practice Address - Fax:518-373-7967
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
J400085101Medicare PIN