Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. SHANE FAMILLE, PT, ATC
ActiveMR. SHANE FAMILLE, PT, ATC is a Environmental Modification (OT) healthcare provider located in GLENDORA, New Jersey. NPI 1689781593 is currently active in the NPPES registry. Verify at CMS.
Environmental Modification (OT) · GLENDORA, NJ
Registration Details
- NPI Number
- 1689781593
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 24, 2006 (19.936966171684 yrs)
- Last Updated
- Feb 1, 2010
- Licenses
-
25MT00125600 (NJ)40QA01317800 (NJ)
Practice Information
- Address
-
17 11TH AVEGLENDORA, NJ, 080291333Browse NJ providers · Browse ZIP 08029
- Phone
- 8562160047
- Fax
- 8564279314
- Primary Specialty
-
Environmental Modification (OT)
2251S0007X
- Additional Specialty
- Environmental Modification (OT)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.