MEDICARE: DR. SHAWN W MONAHAN 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	035333	NY

General Provider Information

NPI Number	:	1952650202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWN W MONAHAN DPT

Provider Business Mailing Address
First Line	:	256 WEST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-2014
Country	:	US
Telephone Number	:	716-435-7280
Fax Number	:

Provider Business Practice Location Address
First Line	:	256 WEST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-2014
Country	:	US
Telephone Number	:	716-435-7280
Fax Number	:

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

Provider Enumeration Date	:	08/31/2012
Last Update Date	:	05/30/2021

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