Provider Demographics
NPI:1184957623
Name:SHAW, SHAYNA RACHAEL (DPT)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:RACHAEL
Last Name:SHAW
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 1:6549 BARTLETT ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1833
Mailing Address - Country:US
Mailing Address - Phone:412-638-1716
Mailing Address - Fax:
Practice Address - Street 1:3053 NEW GERMANY RD
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-3516
Practice Address - Country:US
Practice Address - Phone:814-472-1105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019887225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist