Provider Demographics
NPI:1598219156
Name:MCMULLEN, DEANNA FAHRMAN (DPT)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:FAHRMAN
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:FAHRMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 392573
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9500
Mailing Address - Country:US
Mailing Address - Phone:724-343-4060
Mailing Address - Fax:
Practice Address - Street 1:499 IDLEWILD AVE STE 103
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4049
Practice Address - Country:US
Practice Address - Phone:443-537-1297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26385225100000X
DE225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist