Healthcare Provider Details

I. General information

NPI: 1992739585
Provider Name (Legal Business Name): DEBORAH M MACDONALD PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBBIE MACDONALD

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DEMERCURIO DR SUITE 5
ALLENDALE NJ
07401-1717
US

IV. Provider business mailing address

1 DEMERCURIO DR SUITE 5
ALLENDALE NJ
07401-1717
US

V. Phone/Fax

Practice location:
  • Phone: 201-818-2700
  • Fax: 201-818-3023
Mailing address:
  • Phone: 201-818-2700
  • Fax: 201-818-3023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00898800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: