Healthcare Provider Details

I. General information

NPI: 1619564911
Provider Name (Legal Business Name): SHELLEY REGINA CAHN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 ELTING AVE
NEW PALTZ NY
12561-1933
US

IV. Provider business mailing address

48 ELTING AVE
NEW PALTZ NY
12561-1933
US

V. Phone/Fax

Practice location:
  • Phone: 917-747-2547
  • Fax:
Mailing address:
  • Phone: 917-747-2547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: