Provider Demographics
NPI:1376526087
Name:SHYMANSKY, LAURA M (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:SHYMANSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:PORTASIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2585 FREEPORT RD STE 105
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1426
Mailing Address - Country:US
Mailing Address - Phone:412-235-5885
Mailing Address - Fax:412-235-5886
Practice Address - Street 1:2585 FREEPORT RD STE 105
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-1426
Practice Address - Country:US
Practice Address - Phone:412-235-5885
Practice Address - Fax:412-235-5886
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045229E208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011951490002Medicaid
594946Medicare ID - Type Unspecified
E36345Medicare UPIN