Provider Demographics
NPI:1871711333
Name:BRYANT, DEBORAH A (PA-C)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:A
Last Name:BRYANT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:124 DEKALB PIKE
Mailing Address - Street 2:THE NEUROLOGIC GROUP
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454
Mailing Address - Country:US
Mailing Address - Phone:215-699-3727
Mailing Address - Fax:
Practice Address - Street 1:240 UNION STATION PLZ
Practice Address - Street 2:ST LUKE'S UNION STATION
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1281
Practice Address - Country:US
Practice Address - Phone:610-954-4700
Practice Address - Fax:610-954-2074
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003566L363AM0700X
PAOA000530L363A00000X
PAMA0003566L2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine