Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Shane Famille, PT, ATC

Individual provider Athletic Trainer · NPI 1689781593

Mr. Shane Famille, PT, ATC is a Physical Therapist in Private Practice in Glendora, New Jersey. Qualified in 2009, 17 years ago. Licensed in New Jersey.

Years since qualifying
17
Licensed in
NJ
In the registry since
2006
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

See every abbreviation used in this directory →

Practice location Address checks out

17 11th Ave
Glendora, NJ 08029-1333
Phone: (856) 216-0047
Fax: (856) 427-9314
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Physical Therapist (primary) Taxonomy 2251S0007X · Licence 40QA01317800 (NJ)
Athletic Trainer Taxonomy 2255A2300X · Licence 25MT00125600 (NJ)

Record details

NPI number1689781593
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , ATC
Sole proprietorNo
NPI enumeratedAugust 24, 2006
Last updated in NPPESFebruary 1, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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