Provider Demographics
NPI:1750895041
Name:SHANE HEALTH AND STRENGTH PHYSICAL THERAPY PLLCLLC
Entity type:Organization
Organization Name:SHANE HEALTH AND STRENGTH PHYSICAL THERAPY PLLCLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:SHANE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:646-926-1403
Mailing Address - Street 1:280 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-4806
Mailing Address - Country:US
Mailing Address - Phone:646-926-1403
Mailing Address - Fax:
Practice Address - Street 1:280 E 10TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009
Practice Address - Country:US
Practice Address - Phone:646-926-1403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-22
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty