Provider Demographics
NPI:1780984112
Name:DEBORAH J CONTESTABILE
Entity type:Organization
Organization Name:DEBORAH J CONTESTABILE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:CONTESTABILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-415-1429
Mailing Address - Street 1:5560 WILLIAM FLYNN HWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9353
Mailing Address - Country:US
Mailing Address - Phone:724-415-1429
Mailing Address - Fax:724-234-4815
Practice Address - Street 1:5560 WILLIAM FLYNN HWY
Practice Address - Street 2:SUITE 104
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9353
Practice Address - Country:US
Practice Address - Phone:724-415-1429
Practice Address - Fax:724-234-4815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000007047332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023070280001OtherPA MEDICAID
PA2113050OtherHIGHMARK
PA2113050OtherHIGHMARK