Provider Demographics
NPI:1770203176
Name:SHAFIK, JOVANNA
Entity type:Individual
Prefix:
First Name:JOVANNA
Middle Name:
Last Name:SHAFIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 SUMMERHILL RD
Mailing Address - Street 2:
Mailing Address - City:SPOTSWWOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884
Mailing Address - Country:US
Mailing Address - Phone:732-353-5655
Mailing Address - Fax:732-993-7618
Practice Address - Street 1:377 SUMMERHILL RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4537
Practice Address - Country:US
Practice Address - Phone:732-353-5655
Practice Address - Fax:732-993-7618
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04212800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist