Provider Demographics
NPI:1730302423
Name:MUHAMMAD, DEBRA D (PTA)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:D
Last Name:MUHAMMAD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOPKINS LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-1727
Mailing Address - Country:US
Mailing Address - Phone:609-877-8760
Mailing Address - Fax:
Practice Address - Street 1:2305 RANCOCAS RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4113
Practice Address - Country:US
Practice Address - Phone:609-747-8619
Practice Address - Fax:609-239-3078
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00236300225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant