Mr. Shane Famille, PT, ATC
Physical Therapist, Sports in Glendora, New Jersey
1689781593- Practice location
- 17 11TH Ave, Glendora, NJ 08029-1333
- Phone
- 856-216-0047
- Fax
- 856-427-9314
- Last updated
- February 1, 2010
Shane Famille is a Physical Therapist, Sports based in Glendora, NJ. Shane Famille practices in Glendora, NJ and has the professional credentials of PT, ATC. The NPI Number for Shane Famille is 1689781593 and holds a License No. 25MT00125600 (NJ). The current practice location address for Shane Famille is 17 11TH Ave, Glendora, NJ 08029-1333 and can be reached out via phone at 856-216-0047 and via fax at 856-427-9314.
Provider Profile Details
- NPI Number
- 1689781593
- Provider Name
- Shane Famille
- Credential
- PT, ATC
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 17 11TH Ave, Glendora, NJ 08029-1333
- Phone Number
- 856-216-0047
- Fax Number
- 856-427-9314
- Primary Taxonomy
- Physical Therapist, Sports · 2251S0007X
- Sole Proprietor
- No
- Provider Enumeration Date
- August 24, 2006
- Last Update Date
- February 1, 2010
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 17 11TH Ave
Glendora, NJ 08029-1333 - City
- Glendora
- State
- New Jersey
- Zip
- 08029-1333
- Phone Number
- 856-216-0047
- Fax Number
- 856-427-9314
Provider Business Mailing Address Details
- Address
- 17 11TH Ave
Glendora, NJ 08029-1333 - City
- Glendora
- State
- NJ
- Zip
- 08029-1333
- Phone Number
- 856-216-0047
- Fax Number
- 856-427-9314
License Information
- License Number (1)
- 25MT00125600
- License State (1)
- NJ
- Taxonomy (1)
- Specialist/Technologist, Athletic Trainer · 2255A2300X
- License Number (2)
- 40QA01317800
- License State (2)
- NJ
- Taxonomy (2)
- Physical Therapist, Sports · 2251S0007X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Physical Therapist, Sports providers near Glendora, NJ
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Frequently Asked Questions
What is the NPI number of Mr. Shane Famille, PT, ATC?
The NPI number of Mr. Shane Famille, PT, ATC is 1689781593. It was assigned on August 24, 2006 and is currently active in the NPPES registry.
What is the specialty of Mr. Shane Famille, PT, ATC?
Mr. Shane Famille, PT, ATC is registered under the primary taxonomy Physical Therapist, Sports (code 2251S0007X), licensed in NJ under license number 25MT00125600.
Where does Mr. Shane Famille, PT, ATC practice?
The practice location is 17 11TH Ave, Glendora, NJ 08029-1333. The office can be reached at 856-216-0047 (phone) or 856-427-9314 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1689781593 directly on the NPPES registry website.