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General NPI Number Information
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NPI Number | 1598450157
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Entity Type | Individual
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Provider Name | SHANEISA MAGAMBO
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Gender | Female
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 930 MANTON WAY
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City | PITTSBURGH
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State | PA
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Zip | 15210-1744
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Country | US
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Telephone | 814-691-1618
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Fax |
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Provider Business Mailing Address
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Address Line | 930 MANTON WAY
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City | PITTSBURGH
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State | PA
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Zip | 15210-1744
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Country | US
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Telephone | 814-691-1618
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Fax | 412-207-3551
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | G9T8F4K3
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | 22466
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH007807
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License Number State | PA
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