Provider Demographics
NPI:1386902468
Name:SHAFRAN TOPAZ, LEAH (BPT)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:SHAFRAN TOPAZ
Suffix:
Gender:F
Credentials:BPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4713 HAZEL AVE
Mailing Address - Street 2:APT. 4
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-2077
Mailing Address - Country:US
Mailing Address - Phone:267-994-2479
Mailing Address - Fax:
Practice Address - Street 1:4713 HAZEL AVE
Practice Address - Street 2:APT. 4
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-2077
Practice Address - Country:US
Practice Address - Phone:267-994-2479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033996225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist