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NPI Code Detail

MEDICARE: SHANNA NAIDER

MEDICARE: SHANNA NAIDER
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 TherapistPT026020PA

General Provider Information

NPI Number : 1518487933
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNA NAIDER
Provider Business Mailing Address
First Line : 1377 MOTOR PKWY STE 307
Second Line :
City : ISLANDIA
State : NY
Zip : 11749-5258
Country : US
Telephone Number : 631-580-5200
Fax Number : 631-824-9219
Provider Business Practice Location Address
First Line : 233 E KING ST STE 103
Second Line :
City : MALVERN
State : PA
Zip : 19355-2574
Country : US
Telephone Number : 484-318-7241
Fax Number : 484-318-1790
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2017
Last Update Date : 06/15/2020

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Directions to “ SHANNA NAIDER ” Practice Location

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