Provider Demographics
NPI:1265025761
Name:SHROBA, LIANNE MARIE (ATC)
Entity Type:Individual
Prefix:MISS
First Name:LIANNE
Middle Name:MARIE
Last Name:SHROBA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-1508
Mailing Address - Country:US
Mailing Address - Phone:845-826-4588
Mailing Address - Fax:
Practice Address - Street 1:6 FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-1508
Practice Address - Country:US
Practice Address - Phone:845-826-4588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer