Provider Information for 1043416845
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DEBORAH LEE BEVVINO
Sex: Female
NPI: 1043416845
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1043416845 | ||||||||
| Enumeration Date | 2007-06-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 14623 READING, PA 19612-4623 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 6TH AVENUE & SPRUCE STREET WEST READING, PA 19611 United States Phone: 610-988-8070 | Fax: | ||||||||
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