NPIMap

Organization Active NPI

Sunshine Therapy Club

  • Early Intervention Provider Agency
  • Drexel Hill, PA
National Provider Identifier
1093015356
Registry record updated Nov 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
SUNSHINE THERAPY CLUB
Practice address
3300 Township Line Rd
Suite 102
Drexel Hill, PA 19026-1925
Phone
(610) 853-9919
Fax
(610) 853-9921
NPI assigned
Nov 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Taraya J Shirdan, LPT, M.ED.NPI 1386952984
Title
Executive Director
Phone
(610) 853-9919

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

3300 Township Line Rd
Suite 102
Drexel Hill, PA 19026-1925

Mailing address

3300 Township Line Rd
Suite 102
Drexel Hill, PA 19026-1925
Phone (610) 853-9919

Other identifiers 1

IdentifierTypeStateIssuer
1000061970004MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Sunshine Therapy Club Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3300 Township Line Rd
#102
Drexel Hill, PA 19026
Phone (610) 853-9919

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1093015356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 TOWNSHIP LINE RD",
            "address_2": "SUITE 102",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190261925",
            "telephone_number": "610-853-9919",
            "fax_number": "610-853-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 TOWNSHIP LINE RD",
            "address_2": "SUITE 102",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190261925",
            "telephone_number": "610-853-9919",
            "fax_number": "610-853-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE THERAPY CLUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "SHIRDAN",
        "authorized_official_first_name": "TARAYA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "610-853-9919",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPT, M.ED."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000061970004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Drexel Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.