Provider Demographics
NPI:1689844037
Name:PEKDEMIR, SHAZIYE
Entity Type:Individual
Prefix:MISS
First Name:SHAZIYE
Middle Name:
Last Name:PEKDEMIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 COOLIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1655
Mailing Address - Country:US
Mailing Address - Phone:917-742-3584
Mailing Address - Fax:
Practice Address - Street 1:197 COOLIDGE DR
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1655
Practice Address - Country:US
Practice Address - Phone:917-742-3584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023691225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist