MEDICARE: RHUNA SHEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	MT184539	PA
2	207RC0000X	Cardiovascular Disease Physician	MD421566	PA
3	207RI0011X	Interventional Cardiology Physician	MD421566	PA
4	207RC0000X	Cardiovascular Disease Physician	25MA07608300	NJ
5	207RI0011X	Interventional Cardiology Physician	25MA07608300	NJ

General Provider Information

NPI Number	:	1114089729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHUNA SHEN MD

Provider Business Mailing Address
First Line	:	PO BOX 416457
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-6457
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 VALLEY RD
Second Line	:	SUITE 102
City	:	MOUNT ARLINGTON
State	:	NJ
Zip	:	07856-2316
Country	:	US
Telephone Number	:	973-770-7899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	02/23/2016

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