Provider Demographics
NPI:1053125443
Name:HICKEY, MAURA EILEEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:EILEEN
Last Name:HICKEY
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 IROQUOIS DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-5210
Mailing Address - Country:US
Mailing Address - Phone:412-310-1393
Mailing Address - Fax:
Practice Address - Street 1:116 DEFENSE HWY STE 101
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7040
Practice Address - Country:US
Practice Address - Phone:410-897-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT033025225100000X
MD30303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist