Provider Demographics
NPI:1881101137
Name:CIGNA, DEBORAH ANN (PTA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:CIGNA
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 1:65 ARDMOUR DR
Mailing Address - Street 2:
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-2017
Mailing Address - Country:US
Mailing Address - Phone:631-790-1272
Mailing Address - Fax:
Practice Address - Street 1:65 ARDMOUR DR
Practice Address - Street 2:
Practice Address - City:MASTIC
Practice Address - State:NY
Practice Address - Zip Code:11950-2017
Practice Address - Country:US
Practice Address - Phone:631-790-1272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05376225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant