Provider Demographics
NPI:1063511657
Name:EUN H. SHEEN, M.D., P.C.
Entity Type:Organization
Organization Name:EUN H. SHEEN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EUN HO
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-567-0404
Mailing Address - Street 1:460 SYLVAN AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2923
Mailing Address - Country:US
Mailing Address - Phone:201-567-0404
Mailing Address - Fax:201-567-5590
Practice Address - Street 1:460 SYLVAN AVE STE 205
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2923
Practice Address - Country:US
Practice Address - Phone:201-567-0404
Practice Address - Fax:201-567-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001386171100000X
NJ171100000X
NJMA03956200207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3700704Medicaid