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General NPI Number Information
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NPI Number | 1285277293
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Entity Type | Individual
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Provider Name | DEBORAH LYNN ATWELL PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 3400 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4238
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Country | US
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Telephone | 215-662-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 643 S 9TH ST
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City | LINDENHURST
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State | NY
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Zip | 11757-5543
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Country | US
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Telephone | 631-241-3531
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA061225
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License Number State | PA
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