Provider Demographics
NPI:1508116179
Name:STEELE, SHAWNA EMILY (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:EMILY
Last Name:STEELE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921-1552
Mailing Address - Country:US
Mailing Address - Phone:607-765-0715
Mailing Address - Fax:
Practice Address - Street 1:131 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:NY
Practice Address - Zip Code:10921-1552
Practice Address - Country:US
Practice Address - Phone:607-765-0715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010482-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist