Provider Demographics
NPI:1003110347
Name:JERSEY FORENSIC CONSULTING, LLC
Entity Type:Organization
Organization Name:JERSEY FORENSIC CONSULTING, LLC
Other - Org Name:VIVIAN SHNAIDMAN M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHNAIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-910-1715
Mailing Address - Street 1:181 CHERRY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-7911
Mailing Address - Country:US
Mailing Address - Phone:609-910-1715
Mailing Address - Fax:609-964-1700
Practice Address - Street 1:181 CHERRY VALLEY RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7911
Practice Address - Country:US
Practice Address - Phone:609-910-1715
Practice Address - Fax:609-964-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA063105002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty