Provider Demographics
NPI:1255870457
Name:MOHAN, SHEENA
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:MOHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 FINNEGAN LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1061
Mailing Address - Country:US
Mailing Address - Phone:609-712-6357
Mailing Address - Fax:888-828-3316
Practice Address - Street 1:1503 FINNEGAN LN
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1061
Practice Address - Country:US
Practice Address - Phone:609-712-6357
Practice Address - Fax:888-828-3316
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 133NN1002X, 172M00000X
NJ18KT01252800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No172M00000XOther Service ProvidersMechanotherapist