Provider Demographics
NPI:1659671410
Name:SHAPIRO, STACY CARIN (DPT)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:CARIN
Last Name:SHAPIRO
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 1:211S GULPH RD 300
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3101
Mailing Address - Country:US
Mailing Address - Phone:610-265-2230
Mailing Address - Fax:610-265-2240
Practice Address - Street 1:211S GULPH RD 300
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3101
Practice Address - Country:US
Practice Address - Phone:610-265-2230
Practice Address - Fax:610-265-2240
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist