Provider Demographics
NPI:1528022969
Name:SHAFRAN, ANDREA (MPT, CLP-LANA)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:SHAFRAN
Suffix:
Gender:F
Credentials:MPT, CLP-LANA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6530 ROUTE 22
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626
Mailing Address - Country:US
Mailing Address - Phone:724-468-4541
Mailing Address - Fax:724-468-8748
Practice Address - Street 1:6530 ROUTE 22
Practice Address - Street 2:SUITE 100
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626
Practice Address - Country:US
Practice Address - Phone:724-468-4541
Practice Address - Fax:724-468-8748
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015294225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist