Provider Demographics
NPI:1881836443
Name:SHKARUPA, LYUBOV (APN)
Entity Type:Individual
Prefix:
First Name:LYUBOV
Middle Name:
Last Name:SHKARUPA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2537 ALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3933
Mailing Address - Country:US
Mailing Address - Phone:908-397-7161
Mailing Address - Fax:973-921-0166
Practice Address - Street 1:2537 ALLEN AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3933
Practice Address - Country:US
Practice Address - Phone:908-397-7161
Practice Address - Fax:973-921-0166
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-28
Last Update Date:2009-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00159700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health