Healthcare Provider Details

I. General information

NPI: 1548761190
Provider Name (Legal Business Name): DEANNA GEBELE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2018
Last Update Date: 02/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 PATTERSON AVE STE 8
SHREWSBURY NJ
07702-4166
US

IV. Provider business mailing address

811 SCOTT AVE
BRICK NJ
08724-2136
US

V. Phone/Fax

Practice location:
  • Phone: 732-842-6600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01703800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: