Provider Demographics
NPI:1265536544
Name:SHEN, EIN YUAN ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:EIN YUAN
Middle Name:ALAN
Last Name:SHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 UNION AVE SUITE 201
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-3290
Mailing Address - Country:US
Mailing Address - Phone:973-372-6663
Mailing Address - Fax:973-372-0322
Practice Address - Street 1:40 UNION AVE SUITE 201
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-3290
Practice Address - Country:US
Practice Address - Phone:973-372-6663
Practice Address - Fax:973-372-0322
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNA 31702207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
49867OtherAETNA
NJ2199904Medicaid
F02363OtherHEALTHNET
P850745OtherOXFORD
F02363OtherHEALTHNET
085997Medicare ID - Type Unspecified