Provider Demographics
NPI:1013148154
Name:SCHILLER, SHANNON N (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:N
Last Name:SCHILLER
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 1:120 ERIE CANAL DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4607
Mailing Address - Country:US
Mailing Address - Phone:585-225-6296
Mailing Address - Fax:585-225-2839
Practice Address - Street 1:120 ERIE CANAL DR
Practice Address - Street 2:SUITE 310
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4607
Practice Address - Country:US
Practice Address - Phone:585-225-6296
Practice Address - Fax:585-225-2839
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015440225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist