Provider Demographics
NPI:1033243811
Name:SHAFERMAN, MARINA BELLA (PA)
Entity Type:Individual
Prefix:MRS
First Name:MARINA
Middle Name:BELLA
Last Name:SHAFERMAN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:SUMMIT MEDICAL GROUP
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-277-8712
Mailing Address - Fax:908-673-7108
Practice Address - Street 1:1 DIAMOND HILL RD
Practice Address - Street 2:SUMMIT MEDICAL GROUP
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2104
Practice Address - Country:US
Practice Address - Phone:908-277-8712
Practice Address - Fax:908-673-7108
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2008-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY007987363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant