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General NPI Number Information
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NPI Number | 1689055857
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Entity Type | Individual
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Provider Name | DEBRA ELAINE COGLIANESE PT, DPT, OCS, ATC
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Gender | Female
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Dates
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Enumeration Date | 06/14/2015
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Last Update Date | 06/14/2015
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Provider Practice Location Address
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Address Line | 608 WAYFIELD RD
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City | WYNNEWOOD
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State | PA
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Zip | 19096-2444
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Country | US
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Telephone | 610-649-3756
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Fax |
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Provider Business Mailing Address
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Address Line | 608 WAYFIELD RD
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City | WYNNEWOOD
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State | PA
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Zip | 19096-2444
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Country | US
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Telephone | 610-649-3756
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT018873
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 9721
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License Number State | MA
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