Individual
DR. DEVAN ALEXANDER SHAMBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
310 TAUGHANNOCK BLVD, ITHACA, NY 14850-3251
(607) 277-3861
Mailing address
101 UPTOWN RD APT 31, ITHACA, NY 14850-1602
(845) 633-4375
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
045562
NY
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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