Provider Demographics
NPI:1134457468
Name:POIESZ, SHON (PT)
Entity type:Individual
Prefix:
First Name:SHON
Middle Name:
Last Name:POIESZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHON
Other - Middle Name:ELIZABETH
Other - Last Name:CARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:947 WILLOWLEAF DR APT 1306
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3682
Mailing Address - Country:US
Mailing Address - Phone:908-963-6148
Mailing Address - Fax:
Practice Address - Street 1:2805 WHIPPLE RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1233
Practice Address - Country:US
Practice Address - Phone:908-963-6148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist