Provider Demographics
NPI:1811418296
Name:SHELL, ROBERT (AUD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:SHELL
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WHITE HORSE RD STE 510
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4411
Mailing Address - Country:US
Mailing Address - Phone:856-627-4400
Mailing Address - Fax:856-627-4401
Practice Address - Street 1:1000 WHITE HORSE RD STE 510
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4411
Practice Address - Country:US
Practice Address - Phone:856-627-4400
Practice Address - Fax:856-627-4401
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231HA2400X, 231HA2500X
NJ41YA00097300231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier