Healthcare Provider Details

I. General information

NPI: 1326495680
Provider Name (Legal Business Name): SHEELA SAJAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ENGLE STREET 4 EAST
ENGLEWOOD NJ
07631
US

IV. Provider business mailing address

76 LAFAYETTE AVE
DUMONT NJ
07628-2738
US

V. Phone/Fax

Practice location:
  • Phone: 201-292-1400
  • Fax:
Mailing address:
  • Phone: 212-942-8774
  • Fax: 212-567-2019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ14866400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: