Provider Demographics
NPI:1386869089
Name:GATES-MATEN, DEBORAH (PT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:GATES-MATEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 STALLION CIR
Mailing Address - Street 2:
Mailing Address - City:UPPER HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19053-1515
Mailing Address - Country:US
Mailing Address - Phone:215-702-1787
Mailing Address - Fax:
Practice Address - Street 1:74 STALLION CIR
Practice Address - Street 2:
Practice Address - City:UPPER HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:19053-1515
Practice Address - Country:US
Practice Address - Phone:215-702-1787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011652L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019350190001OtherMA