Provider Demographics
NPI:1316412083
Name:SHELL-SANCHEZ, FATIMA (MSN)
Entity Type:Individual
Prefix:MRS
First Name:FATIMA
Middle Name:
Last Name:SHELL-SANCHEZ
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-2409
Mailing Address - Country:US
Mailing Address - Phone:914-837-1587
Mailing Address - Fax:
Practice Address - Street 1:716 CENTER AVE
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-2409
Practice Address - Country:US
Practice Address - Phone:914-837-1587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-09
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0450403356163WH0200X
NY533441-1163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ04504403356OtherPRIVATE INSURANCE