Provider Demographics
NPI:1558742965
Name:SHMAYS, PELLA (PT)
Entity Type:Individual
Prefix:
First Name:PELLA
Middle Name:
Last Name:SHMAYS
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 1:48 PLEASANT ST
Mailing Address - Street 2:APT. 8
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3838
Mailing Address - Country:US
Mailing Address - Phone:508-212-4981
Mailing Address - Fax:
Practice Address - Street 1:932 BROADWAY
Practice Address - Street 2:GENESIS HEALTHCARE
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150
Practice Address - Country:US
Practice Address - Phone:617-889-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist