Provider Demographics
NPI:1861823775
Name:BRUST, DEBORAH
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BRUST
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 1:2600 W RUN RD
Mailing Address - Street 2:
Mailing Address - City:MUNHALL
Mailing Address - State:PA
Mailing Address - Zip Code:15120-2869
Mailing Address - Country:US
Mailing Address - Phone:412-462-8002
Mailing Address - Fax:
Practice Address - Street 1:2600 W RUN RD
Practice Address - Street 2:
Practice Address - City:MUNHALL
Practice Address - State:PA
Practice Address - Zip Code:15120-2869
Practice Address - Country:US
Practice Address - Phone:412-462-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001835E225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist