Provider Demographics
NPI:1235275488
Name:FRANKS, SHANTHA VARGHESE (NP)
Entity Type:Individual
Prefix:
First Name:SHANTHA
Middle Name:VARGHESE
Last Name:FRANKS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VETERANS WAY
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4100
Mailing Address - Country:US
Mailing Address - Phone:201-634-8212
Mailing Address - Fax:201-225-0122
Practice Address - Street 1:1 VETERANS WAY
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4100
Practice Address - Country:US
Practice Address - Phone:201-634-8212
Practice Address - Fax:201-225-0122
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00082400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJQ44905Medicare UPIN