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General NPI Number Information
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NPI Number | 1497146229
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Entity Type | Individual
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Provider Name | LISA SHAW P.T.
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Gender | Female
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Dates
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Enumeration Date | 02/16/2015
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 794 UNION ST STE 3
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City | BROOKLYN
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State | NY
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Zip | 11215-7724
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Country | US
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Telephone | 212-759-2282
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Fax | 212-379-2123
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Provider Business Mailing Address
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Address Line | 31 E 32ND ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10016-5595
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Country | US
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Telephone | 212-759-2282
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Fax | 212-379-2123
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 050282-01
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License Number State | NY
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