MEDICARE: SHON POIESZ PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	35802	CA

General Provider Information

NPI Number	:	1134457468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHON POIESZ PT

Provider Business Mailing Address
First Line	:	947 WILLOWLEAF DR APT 1306
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-3682
Country	:	US
Telephone Number	:	908-963-6148
Fax Number	:

Provider Business Practice Location Address
First Line	:	2805 WHIPPLE RD
Second Line	:
City	:	UNION CITY
State	:	CA
Zip	:	94587-1233
Country	:	US
Telephone Number	:	908-963-6148
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2009
Last Update Date	:	11/30/2009

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Directions to “ SHON POIESZ PT” Practice Location

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