Healthcare Provider Details

I. General information

NPI: 1922969690
Provider Name (Legal Business Name): SHAWNA MARIE PAPADIMITRIOU PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 ELIZABETH DR
LANCASTER PA
17601-4406
US

IV. Provider business mailing address

1317 FOXCROFT DR
LANCASTER PA
17601-5215
US

V. Phone/Fax

Practice location:
  • Phone: 717-669-9618
  • Fax:
Mailing address:
  • Phone: 717-669-9618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberTE012501
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: