Provider Demographics
NPI:1891782108
Name:DONINE M. SHAFFER
Entity type:Organization
Organization Name:DONINE M. SHAFFER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/ L, CHT
Authorized Official - Phone:717-877-8811
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
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02855300OtherCAPITAL BLUE CROSS
PA76210OtherHEALTH AMERICA COVENTRY
PA0994637OtherKEYSTONE HEALTH PLAN
PA5451130001Medicare NSC
PA02855300OtherCAPITAL BLUE CROSS