Provider Demographics
NPI:1457706046
Name:CURTIN, SHANNON PATRICIA (PT,DPT)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:PATRICIA
Last Name:CURTIN
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2209
Mailing Address - Country:US
Mailing Address - Phone:347-234-6785
Mailing Address - Fax:
Practice Address - Street 1:157 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2209
Practice Address - Country:US
Practice Address - Phone:347-234-6785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01325100225100000X
NY032012-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist