Provider Demographics
NPI:1841357506
Name:SHININ, JOHN ARTURO (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ARTURO
Last Name:SHININ
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 1:119 N OCEAN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2026
Mailing Address - Country:US
Mailing Address - Phone:631-207-4200
Mailing Address - Fax:631-207-4200
Practice Address - Street 1:119 N OCEAN AVE STE A
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2026
Practice Address - Country:US
Practice Address - Phone:631-207-4200
Practice Address - Fax:631-204-6244
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221648207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02335793Medicaid
NY02335793Medicaid
NYWGB121Medicare PIN