MEDICARE: MRS. CHERYL A PAVLOV-SHAPIRO PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	020185-1	NY

General Provider Information

NPI Number	:	1174976278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL A PAVLOV-SHAPIRO PT

Provider Business Mailing Address
First Line	:	8539 LAMP POST CIR
Second Line	:
City	:	MANLIUS
State	:	NY
Zip	:	13104-9389
Country	:	US
Telephone Number	:	315-289-5990
Fax Number	:

Provider Business Practice Location Address
First Line	:	1398 STATE ROUTE 5
Second Line	:
City	:	CHITTENANGO
State	:	NY
Zip	:	13037-8763
Country	:	US
Telephone Number	:	315-510-3372
Fax Number	:	315-510-3688

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2016
Last Update Date	:	07/03/2019

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Directions to “ MRS. CHERYL A PAVLOV-SHAPIRO PT” Practice Location

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