Provider Demographics
NPI:1891014379
Name:OLENIK, SHANNA E (DPT)
Entity Type:Individual
Prefix:DR
First Name:SHANNA
Middle Name:E
Last Name:OLENIK
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 1:3503 NORTHCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3609
Mailing Address - Country:US
Mailing Address - Phone:305-502-8467
Mailing Address - Fax:
Practice Address - Street 1:23811 CHAGRIN BLVD STE 120
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5555
Practice Address - Country:US
Practice Address - Phone:216-682-0413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL240992251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH240670Medicare PIN