Provider Demographics
NPI:1457439697
Name:SHAY, PATRICIA EILEEN (PT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:EILEEN
Last Name:SHAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:EILEEN
Other - Last Name:COZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5672 W. BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228
Mailing Address - Country:US
Mailing Address - Phone:614-878-9000
Mailing Address - Fax:614-878-8881
Practice Address - Street 1:5672 W. BROAD STREET
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228
Practice Address - Country:US
Practice Address - Phone:614-878-9000
Practice Address - Fax:614-878-8881
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT005375225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist