Provider Demographics
NPI:1306442272
Name:SHAFFO, JOSEPH ALAN (DPT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALAN
Last Name:SHAFFO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 AUGUSTA LN
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-4786
Mailing Address - Country:US
Mailing Address - Phone:412-735-3489
Mailing Address - Fax:
Practice Address - Street 1:515 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:TRAFFORD
Practice Address - State:PA
Practice Address - Zip Code:15085-2702
Practice Address - Country:US
Practice Address - Phone:724-744-0499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026421208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation