Provider Demographics
NPI:1619731999
Name:DIPIETRO, SHANNON (DPT)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:DIPIETRO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 MURRAY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2353
Mailing Address - Country:US
Mailing Address - Phone:540-629-4973
Mailing Address - Fax:
Practice Address - Street 1:2345 MURRAY AVE STE 300
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2353
Practice Address - Country:US
Practice Address - Phone:412-422-4775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist