Provider Demographics
NPI:1255316675
Name:SHEEN, EUN H (MD)
Entity Type:Individual
Prefix:
First Name:EUN
Middle Name:H
Last Name:SHEEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 LINWOOD PLZ STE 319
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3798
Mailing Address - Country:US
Mailing Address - Phone:201-567-0404
Mailing Address - Fax:201-482-8856
Practice Address - Street 1:158 LINWOOD PLZ STE 319
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-3798
Practice Address - Country:US
Practice Address - Phone:201-567-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03956200207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3469257OtherAETNA
NJ6N8111OtherEMPIRE BC
NJ443282OtherWELLCARE
NJ2415310000OtherAMERIHEALTH
NJ4902844OtherCIGNA
NJP3239780OtherOXFORD
NJ3428296OtherAETNA
NJ1255316675OtherU.S. FAMILY HEALTH
2695794OtherG.H.I. EMBLEM HEALTH
NJ3700704Medicaid
NJ60018394OtherHORIZON N.J. HEALTH
NJ0115992OtherAMERIGROUP
NJ1255316675OtherTRICARE
NJ3469257OtherAETNA HMO
NJ1255316675OtherCOVENTRY HEALTH-FIRST HEALTH
D14418Medicare UPIN
NJ256612N6ZMedicare PIN