Healthcare Provider Details

I. General information

NPI: 1003236696
Provider Name (Legal Business Name): SHAUN JOSEPH TOOMEY ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 04/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WESTMINSTER COLLEGE 137 S. MARKET ST.
NEW WILMINGTON PA
16172-0001
US

IV. Provider business mailing address

116 MISSION MEADE DR
NEW CASTLE PA
16105-1604
US

V. Phone/Fax

Practice location:
  • Phone: 724-946-7314
  • Fax: 724-946-6297
Mailing address:
  • Phone: 724-923-0110
  • Fax: 724-946-6297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT000226A
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: