Provider Demographics
NPI:1144909193
Name:ROSENTHAL, SHANI (DPT)
Entity type:Individual
Prefix:
First Name:SHANI
Middle Name:
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7022 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-1881
Mailing Address - Country:US
Mailing Address - Phone:650-224-8921
Mailing Address - Fax:
Practice Address - Street 1:1013 WEXFORD PLAZA DR
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9214
Practice Address - Country:US
Practice Address - Phone:724-934-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist