Provider Demographics
NPI:1528055837
Name:SHAFFER, DONINE M (OTR L CHT)
Entity type:Individual
Prefix:MRS
First Name:DONINE
Middle Name:M
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:OTR L CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173132
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33672-1132
Mailing Address - Country:US
Mailing Address - Phone:717-877-8811
Mailing Address - Fax:717-918-5745
Practice Address - Street 1:850 WALNUT BOTTOM RD STE 306
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3615
Practice Address - Country:US
Practice Address - Phone:717-877-8811
Practice Address - Fax:717-918-5745
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC002641L225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5451130001OtherHEALTHNOW NY
PA683986OtherHIGHMARK
PA2330572OtherAETNA HMO
PA76210OtherHEALTH AMERICA COVENTRY
PA02038201OtherCAPITAL BLUE CROSS
PA670001383OtherPALMETTO RR MEDICARE
PA7176107OtherAETNA PPO
PA683986OtherHIGHMARK
PA7176107OtherAETNA PPO