MEDICARE: SHANICE CARRINGTON DPT

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	045094	NY
2	225100000X	Physical Therapist	30616	MD

General Provider Information

NPI Number	:	1609413814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANICE CARRINGTON DPT

Provider Business Mailing Address
First Line	:	6041 OTTERBEIN LN APT 406
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-7599
Country	:	US
Telephone Number	:	631-377-2719
Fax Number	:

Provider Business Practice Location Address
First Line	:	6041 OTTERBEIN LN APT 406
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-7599
Country	:	US
Telephone Number	:	631-377-2719
Fax Number	:

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

Provider Enumeration Date	:	12/06/2019
Last Update Date	:	03/16/2026

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Directions to “ SHANICE CARRINGTON DPT” Practice Location

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