Healthcare Provider Details

I. General information

NPI: 1619044328
Provider Name (Legal Business Name): DEBORAH LYNN ENGLE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH LYNN SANTULLI P.T.

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 FLETCHER ST
GOSHEN NY
10924-1402
US

IV. Provider business mailing address

2 FLETCHER ST.
GOSHEN NY
10924-1402
US

V. Phone/Fax

Practice location:
  • Phone: 845-294-8806
  • Fax: 845-294-8650
Mailing address:
  • Phone: 845-294-8806
  • Fax: 845-294-8650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number009332-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: