Provider Demographics
NPI:1275794794
Name:JOHN, SHEENA JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:JOSEPH
Last Name:JOHN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SHEENA
Other - Middle Name:K
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:201 LYONS AVE
Mailing Address - Street 2:SUITE D11
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2027
Mailing Address - Country:US
Mailing Address - Phone:973-926-7000
Mailing Address - Fax:
Practice Address - Street 1:2317 CENTER ISLAND ROUTE 22
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:201-354-1951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08392400207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine