Provider Demographics
NPI:1962812875
Name:DE, SHREEMAYEE (DO)
Entity Type:Individual
Prefix:DR
First Name:SHREEMAYEE
Middle Name:
Last Name:DE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:20 PROSPECT AVE STE 715
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1989
Mailing Address - Country:US
Mailing Address - Phone:551-996-9189
Mailing Address - Fax:201-836-8042
Practice Address - Street 1:20 PROSPECT AVE STE 715
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1989
Practice Address - Country:US
Practice Address - Phone:551-996-9189
Practice Address - Fax:201-836-8042
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB10220100207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty