Provider Demographics
NPI:1306278098
Name:NEBEL, DEIRDRE J (MSPT)
Entity type:Individual
Prefix:MRS
First Name:DEIRDRE
Middle Name:J
Last Name:NEBEL
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:65 EASTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1030
Mailing Address - Country:US
Mailing Address - Phone:914-741-0321
Mailing Address - Fax:
Practice Address - Street 1:1 SKYLINE DR
Practice Address - Street 2:SUITE 298
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2157
Practice Address - Country:US
Practice Address - Phone:914-347-5990
Practice Address - Fax:914-347-5236
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024424-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist