Provider Demographics
NPI:1336597723
Name:SHELDON, SHIRA (APN)
Entity Type:Individual
Prefix:MRS
First Name:SHIRA
Middle Name:
Last Name:SHELDON
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 1:3270 STATE ROUTE 27
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1496
Mailing Address - Country:US
Mailing Address - Phone:732-422-2400
Mailing Address - Fax:732-463-6087
Practice Address - Street 1:3270 STATE ROUTE 27
Practice Address - Street 2:SUITE 1200
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1496
Practice Address - Country:US
Practice Address - Phone:732-422-2400
Practice Address - Fax:732-463-6087
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00616500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily