Provider Demographics
NPI:1447322714
Name:FENSTERSZAUB, SHAINDY (DPT)
Entity type:Individual
Prefix:MRS
First Name:SHAINDY
Middle Name:
Last Name:FENSTERSZAUB
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 1:3545 MAGELLAN CIR
Mailing Address - Street 2:APT 354
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3719
Mailing Address - Country:US
Mailing Address - Phone:347-276-1979
Mailing Address - Fax:
Practice Address - Street 1:3545 MAGELLAN CIR
Practice Address - Street 2:APT 354
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3719
Practice Address - Country:US
Practice Address - Phone:347-276-1979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24658OtherLICENSE