Individual
MS. DEBORAH SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
717 BETHLEHEM PIKE, SUITE 210, ERDENHEIM, PA 19038-8111
(267) 285-0067
(267) 285-0069
Mailing address
2235 BRANDYWINE ST, PHILADELPHIA, PA 19130-3108
(215) 557-7768
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA00828300
NJ
225100000X
Physical Therapist
Primary
PT007003L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430583
PA BLUE SHIELD PROVIDER #
PA
Enumeration date
12/04/2006
Last updated
04/17/2014
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