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NPI Code Detail

MEDICARE: MS. MARIA R SHANLEY RPT

MEDICARE: MS. MARIA R SHANLEY RPT
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
12251X0800XOrthopedic Physical Therapist005010CT

General Provider Information

NPI Number : 1700883493
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIA R SHANLEY RPT
Provider Business Mailing Address
First Line : 9 WASHINGTON AVE
Second Line :
City : HAMDEN
State : CT
Zip : 06518-3267
Country : US
Telephone Number : 203-865-6784
Fax Number : 203-865-6788
Provider Business Practice Location Address
First Line : 9 WASHINGTON AVE
Second Line :
City : HAMDEN
State : CT
Zip : 06518-3267
Country : US
Telephone Number : 203-789-8873
Fax Number : 203-466-8527
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 12/09/2020

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Directions to “ MS. MARIA R SHANLEY RPT” Practice Location

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