Provider Demographics
NPI:1558329227
Name:SHIFRIN-DOUGLAS, SVETLANA V (MD)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:V
Last Name:SHIFRIN-DOUGLAS
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 1:135 ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3766
Mailing Address - Country:US
Mailing Address - Phone:848-308-4924
Mailing Address - Fax:
Practice Address - Street 1:135 ROUTE 35
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3766
Practice Address - Country:US
Practice Address - Phone:855-660-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420389207RE0101X, 207R00000X
NJ25MA08498100174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine