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NPI Code Detail

MEDICARE: DR. SHANE HOGARTH DPT

MEDICARE: DR. SHANE HOGARTH DPT
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
1225100000XPhysical TherapistPT034215PA

General Provider Information

NPI Number : 1295663623
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANE HOGARTH DPT
Provider Business Mailing Address
First Line : 519 FERNCASTLE DR
Second Line :
City : DOWNINGTOWN
State : PA
Zip : 19335-4844
Country : US
Telephone Number : 484-889-1012
Fax Number :
Provider Business Practice Location Address
First Line : 511 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19123-3230
Country : US
Telephone Number : 215-923-6031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2026
Last Update Date : 05/13/2026

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