Provider Demographics
NPI:1194198465
Name:TOOMEY, SHAINA RAE (MSPT)
Entity Type:Individual
Prefix:MS
First Name:SHAINA
Middle Name:RAE
Last Name:TOOMEY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WATSON LN
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-1751
Mailing Address - Country:US
Mailing Address - Phone:413-388-9393
Mailing Address - Fax:
Practice Address - Street 1:96 PROSPECT HILL RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06088-9668
Practice Address - Country:US
Practice Address - Phone:860-623-9846
Practice Address - Fax:860-393-1887
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-08
Last Update Date:2015-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006746225100000X
MA15427225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist