Individual
MR. BRIAN C SHAK
Active
Individual
MR. BRIAN C SHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013574L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01133301
CAPITAL BLUE CROSS PROVID
PA
01
—
1300887
BLUE SHILED PROVIDER ID
PA
01
—
7692221
AETNA PROVIDER ID
PA
01
—
P00028339
RR MEDICARE PROVIDER ID
PA
01
—
P2607186
OXFORD PROVIDER ID
PA
Enumeration date
04/12/2006
Last updated
07/13/2026
Update your record
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