Provider Demographics
NPI:1801483888
Name:MUNESHWAR, SHELLINIE D (NP)
Entity type:Individual
Prefix:
First Name:SHELLINIE
Middle Name:D
Last Name:MUNESHWAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:SHELLINIE
Other - Middle Name:D
Other - Last Name:MUNESHWAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:67 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1017
Mailing Address - Country:US
Mailing Address - Phone:155-135-8626
Mailing Address - Fax:
Practice Address - Street 1:585 RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-4823
Practice Address - Country:US
Practice Address - Phone:201-997-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01079000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily