Healthcare Provider Details

I. General information

NPI: 1619919412
Provider Name (Legal Business Name): DEBRA ANN HANSELMAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: DEBRA ANN LUCAS PT

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 CORPORATE DR STE 100
PITTSBURGH PA
15237-7005
US

IV. Provider business mailing address

5900 CORPORATE DR STE 100
PITTSBURGH PA
15237-7005
US

V. Phone/Fax

Practice location:
  • Phone: 412-369-7735
  • Fax: 412-369-7704
Mailing address:
  • Phone: 412-369-7735
  • Fax: 412-369-7704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT002071E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: