National Provider Identifier
Devan Alexander Shambo, DPT
Devan Alexander Shambo, DPT is listed in the NPPES registry with a primary specialty of Orthopedic Physical Therapist in Ithaca, NY and a listed phone number of (607) 277-3861.
Profile Overview
- NPI
- 1609409358
- Provider Type
- Individual
- Primary Specialty
- Orthopedic Physical Therapist
- Enumeration Date
- February 20, 2020
- Last Updated
- February 20, 2020
Practice Location
- 310 Taughannock Blvd
- Ithaca, NY 14850-3251
Phone: (607) 277-3861
Mailing Address
- 101 Uptown RD Apt 31
- Ithaca, NY 14850-1602
Specialties
- Orthopedic Physical Therapist (2251X0800X)
Endpoints
- dshambo@cayugamed.org
Direct Messaging Address | Direct | Other | Ithaca, NY 14850
Personal
Full Record
- NPI
- 1609409358
- Entity Type
- Individual
- Last Name
- Shambo
- First Name
- Devan
- Middle Name
- Alexander
- Name Prefix
- Dr.
- Credential
- DPT
- Mailing Street Address
- 101 Uptown RD Apt 31
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1602
- Mailing Country
- US
- Mailing Phone
- (845) 633-4375
- Practice Street Address
- 310 Taughannock Blvd
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-3251
- Practice Country
- US
- Practice Phone
- (607) 277-3861
- Enumeration Date
- February 20, 2020
- Last Updated
- February 20, 2020
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- February 20, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Orthopedic Physical Therapist (2251X0800X)