MEDICARE: MR. SHAWN R NOTARIONE

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	2251X0800X	Orthopedic Physical Therapist

General Provider Information

NPI Number	:	1356805543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHAWN R NOTARIONE

Provider Business Mailing Address
First Line	:	50 BAKER BLVD STE O
Second Line	:
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-3674
Country	:	US
Telephone Number	:	330-869-6344
Fax Number	:	330-869-6366

Provider Business Practice Location Address
First Line	:	50 BAKER BLVD STE O
Second Line	:
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-3674
Country	:	US
Telephone Number	:	330-869-6344
Fax Number	:	330-869-6366

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

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	01/22/2019

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